Survival following simultaneous liver-lung versus liver alone transplantation: Results of the US national experience

Joshua Purvis, Chandler McLeod, Blair Smith, Babak J. Orandi, Cozette Kale, David S. Goldberg, Devin E. Eckhoff, Jayme E. Locke, Robert M. Cannon

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There are little data to compare the post-transplant survival between lung-liver transplant (LLT) and liver-alone recipients. This study was undertaken to compare survival between LLT and liver-alone transplant. Methods: UNOS data for patients undergoing LLT from 2002 to 2017 was analyzed. LLT recipients (n = 81) were matched 1:4 to liver-alone recipients (n = 324) by propensity score and patient survival was compared in the matched cohorts. Results: Unadjusted 1, 3, and 5-year patient survival in the matched cohort was significantly worse in the LLT (82.5%, 72.2%, and 62.2%) versus liver-alone (92.2%, 82.8%, and 80.9%; p = 0.005). This difference persisted after adjusting for covariates with residual imbalance (HR 2.05, 95% CI 1.37–3.08; p = 0.001). Conclusion: LLT has significantly worse survival than liver-alone transplant. With an increasing organ shortage, medical necessity criteria such as those developed for simultaneous liver-kidney transplantation should be developed for simultaneous lung-liver transplants to assure liver allografts are only allocated when truly needed.

Original languageEnglish (US)
Pages (from-to)813-818
Number of pages6
JournalAmerican journal of surgery
Volume222
Issue number4
DOIs
StatePublished - Oct 2021

Keywords

  • Liver allocation
  • Liver transplantation
  • Propensity matching
  • Simultaneous thoracic abdominal transplantation

ASJC Scopus subject areas

  • Surgery

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