LIVER TRANSPLANTATION

liver411

December 2003 . Volume 9 . Number 12

Review

Evolution of liver transplantation in Europe: Report of the European Liver
Transplant Registry

René Adam* [MEDLINE LOOKUP]
Paul McMaster? [MEDLINE LOOKUP]
John G. O'Grady? [MEDLINE LOOKUP]
Denis Castaing§ [MEDLINE LOOKUP]
Jurgen L. Klempnauer [MEDLINE LOOKUP]
Neville Jamieson¶ [MEDLINE LOOKUP]
Peter Neuhaus# [MEDLINE LOOKUP]
Jan Lerut** [MEDLINE LOOKUP]
Mauro Salizzoni?? [MEDLINE LOOKUP]
Stephen Pollard?? [MEDLINE LOOKUP]
Ferdinand Muhlbacher§§ [MEDLINE LOOKUP]
Xavier Rogiers [MEDLINE LOOKUP]
Juan Carlos Garcia Valdecasas¶¶ [MEDLINE LOOKUP]
Joaquin Berenguer## [MEDLINE LOOKUP]
Daniel Jaeck*** [MEDLINE LOOKUP]
Enrique Moreno Gonzalez??? [MEDLINE LOOKUP]
European Liver Transplant Association


   Abstract
The European Liver Transplant Registry (ELTR) currently allows for the
analysis of 44,286 liver transplantations (LTs) performed on 39,196 patients
in a 13-year period. After an exponential increase, the number of LTs is
plateauing due to a lack of organs. To cope with this, alternatives to
cadaveric LT, such as split LT, domino LT, or living-related LT (LRLT) are
being used increasingly. They now account for 11% of all procedures. One of
the most important findings in the evolution of LT is the considerable
improvement of results along time with, for the mean time, a one-year
survival of 83%, all indications confounded. The improvement is particularly
significant for cancers. This improvement is mainly represented by
hepatocellular carcinoma, with a gain of 17% for 5-year survival rate from
1990 to 2000. Increasingly, older donors are used to augment the donor pool
and older recipients are transplanted due to improved results and a better
selection of patients. More than two thirds of deaths and three quarters of
retransplantations occurred within the first year of transplantation.
Retransplantation is associated with much less optimal results than first
LT. One of the prominent features of recent years is the development of
LRLT. LRLT is now performed by almost half of the European centers. As with
split LT or domino LT, LRLT aims to provide more patients to be
transplanted. Special attention is paid to reducing the risk for the donor,
which is now estimated to be 0.5% mortality and 21% postoperative morbidity.
(Liver Transpl 2003;9:1231-1243.)

   Publishing and Reprint Information
From the *European Liver Transplant Registry; §Hôpital Paul Brousse,
Villejuif; ***Centre Hospitalier Régional Universitaire de Strasbourg,
Strasbourg, France; ?The Queen Elizabeth Hospital, Birmingham; ?King's
College Hospital, London; ¶Addenbrooke's Hospital, Cambridge; ??St Jame's
and Seacroft University Hospital, Leeds, UK; Medizinische Hochschule
Hannover, Hannover; #Charité Campus, Virchow Klinikum, Berlin;
Universitatskrankenhaus Eppendorf, Hamburg, Germany; **Cliniques
Universitaires Saint Luc, Brussels, Belgium; ??Centro de Trapianti di
Fegato, Torino, Italy; §§Klinishe Abteilung für Transplantation, Wien,
Austria; ??Hospital Clinic I Provincial de Barcelona; ##Hospital
Universitario La Fe, Valencia; and ???Hospital 12 de Octubre, Madrid, Spain.

The order of the 16 coauthors was determined according to the decreasing
number of liver transplantations recorded in the European Liver Transplant
Registry.
The registry is supported in part by a grant from Novartis, Fujisawa, and
Roche; and logistic support of the Paul Brousse Hospital (Assistance
Publique, Hôpitaux de Paris). The European Liver Transplant Registry is a
service of the European Liver Transplant Association.

Address reprint requests to René Adam, MD, PhD, Centre Hépatobiliaire,
Hôpital Paul Brousse, 12-14 Av Paul-Vaillant-Couturier, BP 200, F-94804
Villejuif Cedex, France. Telephone: +331-4559-3288; FAX: +331-4559-3857;
E-mail: [email protected]

Copyright © 2003 by the American Association for the Study of Liver Diseases
1527-6465/03/0912-0001$30.00/0
doi:10.1016/j.lts.2003.09.018