Medline ® Abstract for Reference 64

BACKGROUND: The purpose of this study was to examine the long-term survival and causes of death in patients who survive the first year after liver transplantation.

METHODS: The focus of the analysis was 433 patients who survived for at least 1 year after liver transplantation between November 1, 1984, and December 31, 2001. A total of 586 liver transplants were performed in 542 patients during this time period. The overall 1-, 5-, and 10-year survivals and the 5- and 10-year survivals for those patients who lived for a year were analyzed on the basis of Kaplan-Meier survival estimates. Factors examined included diagnosis, sex, age, and retransplantation. The causes of death were also analyzed.

RESULTS: The overall 1-, 5-, and 10-year survivals were 85%, 73%, and 55%, respectively. The 5- and 10-year survivals for those patients who lived for a year were 86% and 65%, respectively. Fifty-one percent of the causes of late death were graft-related, 71% from recurrent primary disease. Cardiovascular events and de novo malignancies were responsible for 65% of the nongraft-related deaths.

CONCLUSIONS: The long-term survival in patients who survive for the first year after liver transplantation is excellent. Recurrent primary disease is responsible for the majority of graft-related deaths. Cardiovascular events and de novo malignancy cause most of the nongraft-related deaths.