Victorian Liver Transplant Unit. Annual Report Page 1

Transcription

1 Victorian Liver Transplant Unit Annual Report Page 1

2 Contents Preface... 3 Report Purpose /18 Summary... 4 Total Transplant Activity /18 Activity Summary /18 Transplant Activity and Patient Demographics /18 Referrals and Activation on the Waiting List... 9 Waiting List Numbers /18 Waiting Times... 9 Outcome Data Contact Us Page 2

3 Preface The Victorian Liver Transplant Unit (VLTU) provides adult liver transplant services for all of Victoria and Tasmania and is currently the sole provider of intestinal transplant services in Australia. The VLTU provides the surgical team and physicians for all paediatric liver transplants performed at the Royal Children s Hospital (RCH). The paediatric service is a Nationally Funded Centre, so patients are referred from a wider geographic area. The VLTU was established in 1988, performing 4 liver transplants in its first year. In 2017/18, a total of 87 liver transplants were performed. The VLTU provides a referral, assessment and transplantation service for patients with hepatocellular carcinoma and/or end stage liver disease. A multidisciplinary team that includes surgeons, hepatologists, allied health and nursing staff manages each patient s journey. In additional to a 24/7 liver transplant coordination service, the Transplant Unit provides long-term follow-up care for patients following their liver transplant. The unit seeks to be renowned for excellence and leadership in healthcare and education. Report Purpose This report has been developed to provide referring physicians with an update on 2017/18 activity and current outcome data. Page 3

4 2017/18 Summary In 2017/18, the VLTU performed its largest ever number of transplants per financial year. 78 adult transplants were performed at Austin Health and 9 transplants were performed at RCH. The total of 87 transplants is 5% more than the year prior. The number of adult transplants performed exceeded the prior year by 15%. The number of transplants performed continues to be limited by the number of suitable donor organs available. The majority of transplants performed are from brain dead (BD) donors, but we continue to be referred growing numbers of Donation after Circulatory Death (DCD) donors. The rate of DCD referral is increasing faster than growth of actual DCD liver donors. Split grafts continue to make a significant contribution to the number of paediatric transplants performed. In 2017/18 44% of the children transplanted received a split graft. The LTU continues to achieve excellent patient survival results. In 2017/18; one paediatric patient received a liver from a living-related donor. In 2017/18; two patients underwent re-transplant for primary graft non-function. Page 4

5 Total Transplant Activity Total Transplant Activity per Financial Year - Austin and RCH 2017/18 Activity Summary Item Number Total Transplants 87 Adult Transplants 78 Paediatric Transplants 9 Page 5

6 2017/18 Transplant Activity and Patient Demographics Age of Patients Transplanted in 2017/18 (n=87) The mean age of adults transplanted in 2017/18 was 54 years, and the median age was 57 years. The mean age of children transplanted in 2017/18 was 3 years, and the median age was 1 year and 9 months. Page 6

7 Primary Indication for Transplant Adults (n=78) Primary Indication for Transplant Children (n=9) Page 7

8 Type of Liver Donors Braindead (BD) Donor Donation after Circulatory Death (DCD) Donor Adult Transplants 76 2 Paediatric Transplants 9 0 Type of Liver Donor Grafts Split Graft Reduced Graft Living Related Donor Adult Transplants Paediatric Transplants Page 8

9 2017/18 Referrals and Activation on the Waiting List Number of Patients Accepted for Work-Up, Assessed and Activated on the Waiting List in 2017/18 Assessed for Transplant Activated on Waiting List Adult > Child < Waiting List Numbers The following table lists the number of adults and children on the liver transplant waiting list at the end of the 2016/17 and 2017/18 financial years: Date Adults Waiting* Children Waiting* Total Waiting* 30 June June * Active on the waiting list 2017/18 Waiting Times The waiting times in days for all patients transplanted (excluding those transplanted for fulminant liver failure) during 2017/18 were as follows: Waiting Time (days) Mean Median Adults > 18 (n=74) Children < 18 (n=8) Page 9

10 Outcome Data The LTU achieves outstanding outcomes, which can be demonstrated by our patient survival rates. Patient Survival 1 Year 5 Year 10 Year Adults > 18 (n=992) 92.3% 86.4% 81.4% Children < 18 (n=223) 95% 87% 87% Since the first transplant was performed in 1988, LTU s retransplant rates are as follows: Number of Retransplants % of Patients Retransplanted Adults > 18 (n=992) % Children < 18 (n=223) % Of all patients transplanted in Victoria since the program commenced in 1988, 66% of adults and 95% of children are alive. * * Does not include any patients currently under the care of the unit whose transplant was performed elsewhere. Page 10

11 Contact Us For more information, our contact details are as follows: Austin Health Liver Transplant Unit (03) Royal Children s Hospital Department of Gastroenterology (03) Page 11