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What Factors Affect Liver Transplant Survival?

S. Waddell
S. Waddell

Liver transplant survival rates have been steadily increasing over the years since the first such transplant was performed in 1963. There are many factors affecting how well a patient will respond to this transplant surgery, including the age of the donor and the degree of illness of the recipient. In the U.S., the one-year survival rate in 2011 was around 85 percent.

The liver is the largest gland in the human body and is responsible for many vital functions. It stores vitamins and nutrients, and it produces the proteins necessary for blood clotting. It creates bile, which is necessary for digestion. The liver filters and removes toxins from the blood. When the liver cannot perform these functions, the body begins to shut down.

The human liver is one organ that can have a section harvested from a living person.
The human liver is one organ that can have a section harvested from a living person.

Liver transplant surgery is considered major surgery. The surgery can take anywhere from four to 18 hours to perform, and there is substantial risk involved. It is performed only when there is an acute or chronic condition causing incurable liver dysfunction.

There is no cure for liver disease — once it gets severe enough, a transplant is required, even though a recipient will always reject a transplanted liver. Immunosuppressive drugs are good at taking care of this problem, though the liver recipient will have to take this type of drug for the rest of his life. One plus is that the amount of medicine needed usually decreases as the degree of rejection falls with time.

Most liver transplants are done using the donated liver from a deceased donor. The liver transplant survival rate is slightly higher when the donated liver comes from a live donor. This is because the time the new liver spends out of the body and in a cold solution is a critical factor when calculating liver transplant survival chances. The piece of liver taken from a live donor goes almost immediately into the recipient's body, which is much more favorable than using a liver that has been out of the donor's body for a period of time.

Another critical factor in the liver transplant survival rate is the age of the donor. The new liver needs to be similar in size to the liver it is replacing, but the younger the donor, the better. The type of disease or injury that has damaged the liver is also significant. A recipient with hepatitis C virus or cirrhosis has a much lower survival rate than a patient with alcohol liver disease that hasn't yet progressed to cirrhosis, or scarring of the liver.

The health of the recipient also affects the liver transplant survival rate. A patient with coronary disease, diabetes, COPD, connective tissue disease or renal insufficiency will have a lesser chance of survival. There is a national waiting list for liver transplants. It is managed by the United Network for Organ Sharing (UNOS) and all those needing a transplant must be registered and put on the list. They have a scoring system to determine who gets a liver called the model for end-stage liver disease (MELD).

The MELD score goes from 6 to 40, with 6 being less ill and 40 being gravely ill. The sickest people are given top priority. There are always thousands more people waiting to get a liver than there are livers available for transplant each year.

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    • The human liver is one organ that can have a section harvested from a living person.
      The human liver is one organ that can have a section harvested from a living person.