Use of living donor liver transplantation in a high-volume Canadian transplant centre

Publication:  Living donor liver transplantation can address disparities in transplant access for patients with primary sclerosing cholangitis

Published in August 2023, this study, partially funded by PSC Partners Seeking a Cure Canada, analyzed the clinical trajectory over time for patients with PSC, once referred for liver transplant, in a mixed deceased donor/living donor Canadian transplant program and provides real-world evidence for the high use of living donor liver transplantation (LDLT) in this PSC population, as an inference for inadequacies of a MELD-Na organ allocation system.

The data shows a higher rate and dependence on LDLT for people living with PSC than would be expected for other liver transplant indications and significantly increased survival and rates of transplant with access to a potential living liver donor. Access to LDLT for PSC is important in the current MELD-Na era, and this study indirectly highlights that patients with PSC are not adequately served with a pure MELD-Na approach. Future efforts are needed to redesign organ allocation approaches to better address the clinical needs for both common, as well as rare disease indications such as PSC.

Onofrio, Fernanda1; Zheng, Katina2; Xu, Cherry1; Chen, Shiyi3; Xu, Wei3; Vyas, Mary4; Bingham, Katie4; Patel, Keyur1; Lilly, Leslie1; Cattral, Mark1; Selzner, Nazia1; Jaeckel, Elmar1; Tsien, Cynthia1; Gulamhusein, Aliya5; Hirschfield, Gideon M.5; Bhat, Mamatha1,5. Living donor liver transplantation can address disparities in transplant access for patients with primary sclerosing cholangitis. Hepatology Communications 7(8):e0219, August 2023. | DOI: 10.1097/HC9.0000000000000219