Living-Donor Liver Transplant Associated with Improved Long-Term Patient Survival Compared to Deceased-Donor Liver Transplant

A new analysis presented by UPMC physicians and researchers at the 2025 World Transplant Conference demonstrated that living-donor liver transplant was associated with an increased likelihood of long-term recipient survival compared to deceased-donor liver transplant.

Study authors include Abhinav Humar, MD, clinical director, Thomas E. Starzl Transplantation Institute and chief, UPMC Division of Transplant Surgery.

Researchers retrospectively analyzed all-cause mortality in adult and pediatric liver transplant recipients in the U.S. between 1998 and 2022. Recipient data, collected from the Scientific Registry of Transplant Recipients, included 144,761 adult patients and 12,449 pediatric patients.

Kaplan-Meier (K-M) analysis and Cox proportional hazards model analysis were used to calculate how many years recipients were likely to survive posttransplant and account for potential confounding variables. Long-term survival was defined as survival at 10 years and 20 years posttransplant.

When compared to deceased-donor liver transplant, living-donor liver transplant was associated with a 13% reduction in mortality risk among adult recipients (adjusted hazard ratio 0.87; 95% confidence interval 0.83-0.92; P = <0.001). Pediatric patients who received a living-donor liver transplant had a 24% adjusted reduction in mortality risk (adjusted hazard ratio 0.76; 95% confidence interval 0.62-0.94; P <0.01).

The long-term survival benefit of living-donor liver transplant for both adult and pediatric recipients highlights the importance of increasing access to living-donor liver transplantation and reducing burdens for living-liver donors and donor candidates.

UPMC is one of the most experienced transplant centers in the United States, having performed more than 1,000 combined adult and pediatric living-donor liver transplants. This expertise enables UPMC to provide transplant services to individuals with high-risk and complex conditions and offer comprehensive care for living-liver donors and donor candidates.

Read the full abstract.