• S. Afr. Med. J. · Apr 2024

    Wits Transplant Unit Annual Report 2022: Adult and paediatric liver transplantation.

    • E U Wessels, K Kinandu, M Beretta, S Berkenfeld, B Bobat, L Brannigan, R Britz, D Demopoulos, L Doedens, P Gaylard, H Maher, A Mahomed, V Mudau, D Parbhoo, S Rambarran, M Reynders, F Van der Schyff, B Ströbele, J Fabian, and J Loveland.
    • Wits Donald Gordon Medical Centre, University of the Witwatersrand, Johannesburg, South Africa. eu.wessels@gmail.com.
    • S. Afr. Med. J. 2024 Apr 24; 114 (3b): e1365e1365.

    AbstractIn 2022, the Wits Transplant Unit performed 57 liver transplants: 33/57 adult (58%) and 24/57 paediatric (42%) recipients. At the beginning of 2022, 28 candidates were on the adult waitlist. Forty-six candidates were added to the waitlist during the year. Sixty-five percent of waitlisted candidate were transplanted. Adult candidates remained on the waitlist for longer than previous years, with 52% of them waitlisted for less than one year before undergoing liver transplantation. There was a decrease in adult pretransplant mortality to 9% in 2021 from 25% in 2020. The most common aetiology in waitlist candidates was alcoholic steatohepatitis (ASH)/non-alcoholic steatohepatitis (NASH) (36%) and in recipients cholestatic (primary sclerosing cholangitis (PSC) and primary biliary sclerosis (PBC)) (40%). Most adult recipients received a deceased donor graft (79%). Unadjusted recipient one- and three-year survivals were 75% (95% confidence interval (CI) 65 - 83) and 74% (95% CI 65 - 81), respectively. In the paediatric population, the most common aetiologies for both pretransplant candidates and transplant recipients remained cholestatic disease and acute liver failure. There was a decrease in paediatric pretransplant mortality from 27% in 2017 to 6% in 2021. Unlike the adult cohort, most paediatric recipients received a living donor graft (79%). Unadjusted one-year and three-year survival rates were 85% (95% CI 75 - 92) and 68% (95% CI 56 - 77), respectively.

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