Living-donor liver transplant offers numerous advantages over deceased donor

A recent study has highlighted the advantages of living-donor liver transplant over deceased-donor.
According to the study, a living-donor liver transplant offers numerous advantages over deceased-donor transplant, including better 3 year survival rates for patients and lower costs.

The study, highlights living donation as a viable, if not preferable, option for more than 14,000 people currently on the waiting list, as well as many more who never qualify to be on the list under current allocation rules.

About 8,000 liver transplants are performed each year according to  the Organ Procurement and Transplantation Network, and living-donor liver transplant comprises less than 5% of that total.
Additionally, about 25% of people on the waiting list die each year waiting for a transplant, and those who eventually receive a transplant often have a lengthy period on the waiting list, resulting in poorer health at the time of transplant.

The consequences for patients on the waiting list can mean the difference netween life and eath because the longer they're waiting, the sicker they become. Living-donor liver transplants, in tandem with deceased donor liver transplants, represents an opportunity to significantly decrease the risk of wait-list mortality, and gives us the ability to transplant a person sooner, said the lead author of the study.

The retrospective review of 245 adult living donor liver transplants and 592 deceased-donor liver transplants performed over the last 10 years compared survival rates and other outcomes such as recovery times, complications, costs and resource utilisation. The patients were followed for at least two years post-transplant.

Of those comparisons, 3-year patient survival outcomes were superior in living-donor liver transplant recipients - 86 % versus 80 %. Living-donor liver transplant recipients overall had about a 5% survival advantage over deceased donor recipients.

Patients who received a liver from a living donor had a hospital stay of 11 days as compared to 13 days for those who received a liver from a deceased donor, had less likelihood of intra-operative blood transfusion (53 % compared to 78%) and less likelihood of the need for post-transplant dialysis ( 1.6% versus 7.4 %). Hospital costs related to transplant also were 29.5 % lower for living donor recipients. For the living-liver donor, there were no mortalities observed, and the overall complication rate was 20 %.

Living-donor liver transplant should be considered the first and best option for most patients with liver disease, he said. It is not only an option for those on the waiting list but could perhaps offset the fact that not everyone who may benefit from transplant qualifies  to receive a deceased-donor transplant based on today's current rules of allocation.

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With Cancer, Timing Is Everything-BY Khevin Barnes

Khevin Barnes is a Male Breast Cancer survivor, magician and speaker. He is currently writing, composing and producing a comedy stage musical about Male Breast Cancer Awareness. He travels wherever he is invited to speak to (and do a little magic for) men and women about breast cancer. 

 

I had a family member who was diagnosed with late stage ovarian cancer 20 years ago and died of the disease at the age of 47. Even though her symptoms appeared a year before her diagnosis with abdominal bloating, indigestion, loss of appetite and more, the cancer escaped detection. It took a full year of visits to several physicians before the unfortunate news was discovered.

Today the classic CA 125 blood test is available and works well for advanced ovarian cancers. In fact, around 90 percent of women with advanced ovarian cancer have elevated levels of CA 125 in their blood serum, making CA 125 a useful tool for detecting the disease after the onset of symptoms. It's important to note that the doctors recommend against women with average risk of ovarian cancer having routine CA 125 screening or other screening for this cancer since there is evidence that ambiguous test results are common. But in the case of my family member, it may have saved her life.

Timing, it seems, is everything where cancer is concerned.

It's heartening to observe how science scurries to keep up with cancer. According to the oncologists, there are well over 100 different cancer types. If we are lucky enough to be diagnosed at a time when a new "breakthrough" occurs with our particular cancer, our odds of survival may be enhanced.

My own breast cancer was discovered by luck, or should I say lucky timing. Before my first visit with my original primary care doctor in 2014, I had not seen a physician for any purpose for many years. My reason for the visit was simply to “check in,” to become "officially signed up" in the system and to meet the man who might be an important ally should I catch a bad flu or be stung by a jelly fish on the beaches.

By the time I left his office, he had me scheduled for a mammogram to check out a very tiny bump under my left breast. An ultrasound and needle biopsy followed, and before the month was over, I was in surgery, receiving my mastectomy for stage 1, grade 3 male breast cancer, perhaps saving my life.

Timing it seems, is everything where cancer is concerned.

Those of us who have been thrown into the cancer arena learn to keep a close eye on ourselves, our bodies and our symptoms. There's always a chance of cancer recurring.

But at the same time, I believe it’s a good idea to follow the science that occurs virtually every day somewhere in the world.

If you're "lucky" enough to have one of the five most common cancers, you can be certain that researchers are busy trying to unearth a cure for you. If you have fallen victim to an "orphan disease" like I have with male breast cancer, there is still plenty of reason for hope, but perhaps a little luck thrown in may be a good thing, too. Every time someone benefits personally from an innovation or improvement in the quest to rid our planet of cancer (and I'm speaking of all 100 of them), each of us is advancing the whole team, the entire multitude of survivors who, like us, hope to cash in on some good fortune and perhaps some very good timing.

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