New research published in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, reports that younger patients, those who are married, and those with Child-Pugh C disease—the most severe measure of liver disease—are more likely immigrants, divorced patients and those at the lowest income levels were less likely to have a potential live donor volunteer for liver donation.
With a limited supply of deceased donor organs, livers from living donors provide a much needed, life-saving option for those with end-stage liver disease. Despite evidence suggesting that the 5-year recipient survival from the time of wait listing is estimated to be 20% higher with a live donor compared with deceased donor, living donor liver transplantation accounts for only a few percent in many Western countries.
“Given that the demand for liver transplantation is greater than the supply of deceased donor organs, there is an interest in increasing live donation at centers with experience in that method of transplantation,” explains lead author Dr. Eberhard Renner with the University Health Network and University of Toronto in Ontario, Canada. “Our study aims to identify recipient characteristics that are associated with having a living donor volunteer for donation.”
The research team reviewed data from 491 patients listed for liver transplantation at the University transplant center over a 24-month period. There were 245 patients identified who had a least one potential living donor with 70% of these recipients being male and having an average age of 53 years at wait listing. Hepatitis C, alcoholic liver disease and hepatocellular carcinoma were listed as reason for liver transplant in 34%, 20%, and 35% of cases in the study group.
Analyses found that recipients who had potential access to a living donor were more likely to have more severe liver disease (Child-Pugh C). The recipients were less likely to be older, single, divorced, immigrants or from the lowest income levels.
Commenting about the findings Dr. Renner says, “More research is needed to understand and overcome the barriers to live donor liver transplants. Possible interventions like financial assistance and educational programs may help increase liver donation from living donors.”