Outcome and Characteristics of Patients on the Liver Transplant Waiting List: Shiraz Experience

Abstract

 

Background

The only curative therapy for end-stage liver disease is transplantation but due to a shortage of available donor livers the waiting list mortality is high. This study aimed to evaluate the outcome and characteristics of patients on the waiting list for liver transplantation in Shiraz, southern Iran during the period from April 2004 to March 2007.

Methods

Medical records of all chronic liver disease patients ≥14 years that were on the waiting list for liver transplantation at the Nemazee Hospital Organ Transplant Center during April 2004 to March 2007 were reviewed. Hospital records were used to retrieve demographic, clinical and laboratory data. Records of the referring gastroenterologists provided information about the etiology and complications of liver disease. The patients were followed at the end of the study period by clinic visits or telephone contact.

Results

There were 646 patients on the waiting list for liver transplant during April 2004 to March 2007. Hepatitis B was the most common etiology of liver disease (31.2%). Of those on the waiting list, 144 patients 22.3%) underwent liver transplant and 166 (25.7%) died while waiting for a transplant. The mean waiting period for transplant was 6.6 months. Receiving a transplant was correlated with the etiology of liver disease and Rh blood group (p ‹ 0.05) but had no significant association with gender or ABO blood type. Among non-transplanted patients, survival was lower in those who had a history of encepha­lopathy, SBP or uncontrolled ascites and in patients with a Child-Turcotte-Puph (CTP) class C and/or a Model of End-stage Liver Disease (MELD) score ≥15.

Conclusion

Hepatitis B virus is the most common cause of end-stage chronic liver disease amongst patients on the waiting list for liver transplant in Shiraz, southern Iran. Patients with a MELD score ≥15 particularly those with a history of SBP, hepatic encephalopathy or uncontrolled ascites are recommended for waiting list enrollment.