12/2013

The Present Evolution of Liver Transplantation in EuropeEUROPEAN LIVER TRANSPLANT REGISTRY

28 countries - 155 institutions118,441 transplantations - 106,849 patients

From May 1968 to December 2013

www.eltr.org

12/2013

The Present Evolution of Liver Transplantation

1. General evolution of LT in Europe

2. Donor data

3. Recipient data

4. Indications and results

5. Evolution of techniques

6. Mortality and retransplantation

12/2013

The Present Evolution of Liver Transplantation

1. General evolution of LT in Europe

2. Donor data

3. Recipient data

4. Indications and results

5. Evolution of techniques

6. Mortality and retransplantation

12/2013

EUROPEAN LIVER TRANSPLANT REGISTRY28 countries - 155 institutions

118,441 transplantations - 106,849 patientsFrom May 1968 to December 2013

781

2441

4963

1526

1002

21279

15923

16487

557

829

14354

11

2447

1127

2272

2033

500178

20318

2748

1901

4214

1672

42

229

47

162

12/2013

Evolution of 118,364 Liver Transplantations in Europe

* The decrease is owed to the fact that some centers had a delay in the updating of their data to the current development of a new data reporting system,

*

12/2013Evolution of the number of Liver

Transplantations reported to the ELTR

200

300

400

500

600

700

800

900

1000

1100

1200

FRANCE : 19191 GERMANY : 14827GREAT BRITAIN : 14832 SPAIN : 19948ITALY : 13459

(No LT)

12/2013

Evolution of the number of Liver Transplantations by Center

0

20

40

60

80

100

120

FRANCE : 17098 GERMANY : 13237GREAT BRITAIN : 13470 SPAIN : 16692ITALY : 12963

(No LT / Center)

12/2013

The Present Evolution of Liver Transplantation

1. General evolution of LT in Europe

2. Donor data

3. Recipient data

4. Indications and results

5. Evolution of techniques

6. Mortality and retransplantation

12/2013Evolution of Donor Age05/1968 – 12/2013

12/2013

Gender and Age distribution of Liver Donors

01/1988 - 12/2013

12/2013

Graft Survival according to Donor Age in Europe

01/1988 - 12/2013

12/2013

Graft Survival according to Donor Agein Elective Liver Transplantation

01/1988 – 12/2013

12/2013

Graft Survival according to Donor Agein Urgent Liver Transplantation

01/1988 - 12/2013

12/2013

The Present Evolution of Liver Transplantation

1. General evolution of LT in Europe

2. Donor data

3. Recipient data

4. Indications and results

5. Evolution of techniques

6. Mortality and retransplantation

12/2013Age and Sex of Recipients

05/1968 – 12/2013

12/2013Evolution of Recipient Age05/1968 – 12/2013

12/2013

Patient Survival according to Recipient Age

01/1988 - 12/2013

p Log Rank = 0.0001

12/2013

Patient Survival according to Adult Recipient Age

01/1988 - 12/2013

12/2013

Proportion of Pediatric Transplantation by Country 01/1988 - 12/2013

12/2013Primary Indication of Liver

Transplantation in Pediatric Patients05/1968 - 12/2013

12/2013Survival according to Children Recipient Age

01/1988 - 12/2013

Patient Graft

12/2013

Survival of Children < 2 yrs according to the Main Indication in Europe

01/1988 - 12/2013

12/2013

Survival of Children >= 2 yrs according to the Main Indication in Europe

01/1988 - 12/2013

12/2013

Graft Survival according to Adult Recipient Age01/1988 - 12/2013

12/2013

Primary Indications of Liver Transplantion in Elderly Patients (>= 60 Years)

01/1988 - 12/2013

12/2013

Survival of Elderly Recipients (>= 60 Years) according to the Main Indication in Europe

01/1988 - 12/2013

12/2013

The Present Evolution of Liver Transplantation

1. General evolution of LT in Europe

2. Donor data

3. Recipient data

4. Indications and results

5. Evolution of techniques

6. Mortality and retransplantation

12/2013

* Others : Budd Chiari : 869 Benign liver tumors or Polycystic diseases : 1334Parasitic diseases : 84 Other liver diseases : 2047

Primary Diseases leading to Liver Transplantion in Europe

01/1988 - 12/2013

12/2013

Primary Indications of Liver Transplantion in Europe

01/1988 - 12/2013

12/2013

Evolution of Primary Diseases leading to Liver Transplantation in Europe

05/1968 - 12/2013

12/2013

Primary Diseases leading to Liver Transplantion by Country

01/1988 - 12/2013

12/2013

Primary Diseases leading to Liver Transplantation in Adult Recipients

01/1988 - 12/2013

12/2013

Patient and Graft Survival following Liver Transplantation

05/1968 – 12/2013

12/2013

Patient Survival according to the Year of Liver Transplantation

05/1968 – 12/2013

12/2013

Patient Survival according to the Indication01/1988 - 12/2013

12/2013

Patient Survival according to the 1st Indication

01/1988 – 12/2013

12/2013

Graft Survival according to the Urgency of Liver Transplantation

in Europe01/1988 - 12/2013

12/2013Graft Survival according to ABO

Compatibility in Elective Liver Transplantation01/1988 - 12/2013

12/2013

Graft Survival according to ABO Compatibility in Urgent LT

01/1988 - 12/2013

12/2013Liver Transplantation in Europe

Indications of Cirrhosis01/1988 - 12/2013

12/2013

Evolution of Indications for Cirrhosisin Europe

12/2013

Survival of Patients with Cirrhosisas the First Indication (1)

01/1988 - 12/2013

12/2013

Survival of Patients with Cirrhosisas the First Indication (2)

01/1988 - 12/2013

12/2013

Primary Indications of Liver TransplantationFor Virus related Cirrhosis in Europe

01/1988 - 12/2013

12/2013

Survival of Patients with Virus related Cirrhosis as the First Indication

01/1988 - 12/2013

12/2013

Survival of Patients with Virus related Cirrhosis as the First Indication

01/1988 - 12/2013

12/2013

Survival of Patients with Virus related Cirrhosis as the First Indication

01/1988 - 12/2013

12/2013Liver Transplantation in Europe

Indications in Hepato-Biliary Cancers01/1988 - 12/2013

Others: Hepatoblastoma: 261Epithelioid hemangioendothelioma: 186Angiosarcoma: 20

12/2013

Evolution of Indications for Hepato-BiliaryCancers in Europe

05/1968 - 12/2013

12/2013

Survival of Patients with Liver Canceras the First Indication

01/1988 - 12/2013

12/2013

Survival of Patients with HCC with and without underlying Cirrhosis

01/1988 - 12/2013

12/2013Primary Indications of Liver Transplantation

In Patients with Acute Hepatic Failure01/1988 - 12/2013

12/2013

Survival of Patients with Acute Hepatic Failure as the First Indication

01/1988 - 12/2013

12/2013

Primary Indications of Liver Transplantationin Patients with Cholestatic Diseases

01/1988 - 12/2013

12/2013

Survival of Patients with Cholestatic Diseases as the First Indication

01/1988 - 12/2013

12/2013

Primary Indications of Liver Transplantationin Patients with Metabolic Diseases

01/1988 - 12/2013

12/2013

Survival of Patients with Metabolic Diseases as the First Indication

01/1988 - 12/2013

12/2013

Indications of Liver Transplantation for Other liver diseases in Europe

05/1968 - 12/2013

12/2013

Survival of Patients with Other Liver Diseases as the First Indication

01/1988 - 12/2013

12/2013

The Present Evolution of Liver Transplantation

1. General evolution of LT in Europe

2. Donor data

3. Recipient data

4. Indications and results

5. Evolution of techniques

6. Mortality and retransplantation

12/2013

Recipient age Full size Reduced Split liver DominoLiving Donor

0 to 2 969 755 1534 5 12662 to 15 2747 899 1522 4 86615 to 45 25559 232 1061 98 136245 to 60 46603 137 1460 404 2006≥60 19621 49 627 360 724Total 95499 2072 6204 871 6224

Type of Liver Graft according to Recipient Age 01/1988 - 12/2013

12/2013

Graft Survival in Liver Transplantation only vs Liver Combined to other Organ Transplantation

01/1988 - 12/2013

12/2013

Graft Survival according to the Site of Transplantation in Elective LT

01/1988 - 12/2013

12/2013Type of Liver Graft in Europe

according to the Date of Transplantation

12/2013

Graft Survival according to the Type of Graft

01/1988 - 12/2013

12/2013Alternatives to the Use of the Full

SizeCadaveric Liver Grafts in Europe

12/2013

Graft Survival according to the Type of Graft 01/1988 - 12/2013

12/2013

Graft Survival according to the Type of Graft in Elective LT

01/1988 - 12/2013

12/2013

Graft Survival according to the Type of Graft in Urgent LT

01/1988 - 12/2013

12/2013

Graft Survival according to the Cold Ischemic Time in UW Elective LT

01/1988 - 12/2013

12/2013

Graft Survival according to the Cold Ischemic Time in UW Urgent LT

01/1988 - 12/2013

12/2013

Auxiliary vs Non Auxiliary Graft Survival in Elective Liver Transplantation

01/1988 - 12/2013

12/2013

Auxiliary vs Non Auxiliary Graft Survival in Urgent Liver Transplantation

01/1988 - 12/2013

12/2013The Present Evolution of Liver

Transplantation

1. General evolution of LT in Europe

2. Donor data

3. Recipient data

4. Indications and results

5. Evolution of techniques

6. Mortality and retransplantation

12/2013

Liver Transplantation in EuropeMortality and Retransplantation

01/1988 - 12/2013

12/2013

Mortality and RetransplantationAccording to Recipient Age

01/1988 - 12/2013

12/2013

Mortality and RetransplantationAccording to the 1st Indication

01/1988 - 12/2013

12/2013

Graft Survival according to the Number of Liver Transplantations in Europe

01/1988 - 12/2013

12/2013

Graft Survival according to the number of the LT in Elective Cases

01/1988 - 12/2013

12/2013

Graft Survival according to the number of the LT in Urgent Cases

01/1988 - 12/2013

12/2013

Patient Survival according to the number of Liver Transplantations

01/1988 - 12/2013

12/2013

Patient Survival according to the number of LTs in Elective cases for the 1st LT

01/1988 - 12/2013

12/2013

Patient Survival according to the number of LTs in Urgent cases for the 1st LT

01/1988 – 12/2013

12/2013

Mortality following the 1st LT 01/1988 - 12/2013

12/2013

Causes of Retransplant following the 1st LT01/1988 - 12/2013

12/2013

ELTR Coordination Committee

René Adam, MD, PhD.Custodian

Vincent Karam, PhD.Data Manager

Valérie Delvart, MA.Biostatistician

Anne-Marie LammerantSecretary

European Liver Transplant RegistryHôpital Paul BrousseCentre Hépatobiliaire12 Avenue Paul Vaillant Couturier94804 Villejuif, France

Tel. +33 1 45 59 38 28www,eltr.org

12/2013

the support of:

The ELTR continue to evolve thanks to the participation of the 153 centers and to:

the colaboration with: