Chart reviews and prospective data collection were supplemented by additional ascertainment of deaths and transplants through the end of 2008 for patients included in the retrospective study only (n = 112) and through February 2010 for the remaining patients selleck kinase inhibitor (n = 756) under a data use agreement with the Scientific Registry of Transplant Recipients (SRTR). The study cohort utilized for this report included 868 adult liver transplant candidates for whom the first living liver donor was evaluated between February 28, 2002 and August 31, 2009.

For these candidates, median follow-up was 4.6 years (range: 4 days to 7.9 years). Data from DDLT recipients not enrolled in A2ALL but transplanted at A2ALL centers were obtained from SRTR for comparison with A2ALL patients who received DDLT during the same period. The cumulative incidence function was calculated using SAS macro “comprisk.”7 The

MELD scores reported were calculated on laboratory data only8 and ignored MELD exception scores used in organ allocation. Survival analyses, starting at the time of evaluation of each subject’s first potential donor, were employed to compare mortality after LDLT to the conventional transplant strategy of waiting for and potentially receiving DDLT. The non-LDLT group thus included those who received DDLT, those who remained on the waitlist without receiving a liver transplant at study end, and those who died prior to receiving a DDLT. LDLT (n = 4) or DDLT (n = 2) procedures that were aborted intraoperatively due

to recipient conditions were considered transplants. Domino transplants Deforolimus research buy were classified as DDLTs (n = 1). A Cox regression method employing sequential stratification to compare the effect of receipt of LDLT with not receiving LDLT over the entire period of observation was utilized for the primary analysis.1 The sequentially stratified Cox model was adjusted for baseline covariates of age, HCC, hepatitis C virus (HCV), cholestatic liver disease, and MELD score, all determined at the time of first donor evaluation. Multiplicative interactions (effect 上海皓元 modification) between LDLT, HCC, and MELD score were evaluated. An additional Cox regression analysis of posttransplant mortality was performed starting on the day of transplant and compared LDLT versus DDLT adjusted for age, HCC, HCV, cholestatic liver disease, and MELD score at transplant. Survival probabilities in the tables and figures were calculated in the following manner. Survival in the absence of receipt of LDLT was estimated from a Cox regression censored at LDLT. This model was adjusted for age, HCC, HCV, cholestatic disease, and MELD score as above. Depiction of probabilities of survival that encompass both the waiting period for liver transplantation and posttransplant period were estimated by multiplying the waitlist survival probability at the respective LDLT median transplant time by the posttransplant survival probability for LDLT recipients.