TBA (22W121)

Satellite Liver Transplant Centres Improve Access To and Outcomes Of Liver Transplantation: A 20 Year Followup of the First UK Satellite Liver Transplant Centre

Author(s)

N McDougall, I Cadden, R McCorry, C Braniff, L Stratton, M Heneghan, R Taylor, M Jacobs, J Cash

Department(s)/Institutions

Royal Victoria Hospital, Belfast, Kings College Hospital, London, Statistics and Clinical Studies, NHSBT

Introduction

In 2000 the first UK satellite liver transplant clinic was established in Belfast linking with Kings College Hospital (KCH) with the purpose of improving access to liver transplantation (LT) and transplant outcomes for Northern Ireland.

Aims/Background

To assess the impact of a satellite liver transplant unit on access to LT and outcomes.

Method

A retrospective review was performed of all adult first liver transplants carried out for Northern Ireland (NI) through KCH from 1991 until 2020.  Data was gathered for the number of transplants per 100,000 population and post-transplant survival for each decade since 1991. In addition, the survival data for NI was compared to data for rest of UK.  The data and statistical analysis were obtained through NHSBT. 

Results

During the 30 year period from 1 Jan 1991 to 31 Dec 2020, the number of first liver transplants carried out in each decade was as follows. 1991-2000. In NI, 58 LT with 1yr surv 82.5%, 5 yr surv 73.7% and 10yr surv 64.5%. Rest of UK, 3806 with 1yr survival 81.7%, 5yr survival 69.6% and 10yr surv 58.2%. 2001-2010. In NI, 101 LT with 1yr surv 93.1%, 5yr surv 81.1% and 10yr surv 75.1%. For rest of UK, 4300 LT with 1yr surv 89.4%, 5yr surv. 77.7% and 10yr surv 65.0%. 2011-2020. In NI, 187 LT with 1yr surv 95%, 5yr surv 82.1% and 10yr surv 53.8%. For rest of UK, 6210 LT with 1yr surv 94%, 5yr surv 83.5% and 10yr surv 67.7%. The number of transplants carried out per 100,000 persons in NI was 0.3 in first decade from 1991, 0.53 in second decade and 0.99 in third decade.  The overall UK rates for the same 3 decades were 0.59, 0.70 and 0.96 respectively.

Conclusions

The introduction of the first UK liver transplant satellite unit in Belfast in 2000 improved access to transplant for NI from half the UK average to parity with the UK average. Survival figures for NI compare favourably with figures for rest of UK.