The New Zealand Liver Transplant Unit: Auckland District
Health Board.
Stephen R Munn, Helen M Evans, and Edward J Gane
Clinical Transplants 2014, Chapter 11
Abstract
New Zealand is a geographically isolated country with 4.55
million inhabitants. It has endemic hepatitis B (HBV) infection that is
especially evident in Maori and Pacific Island communities and impacts
indications for liver transplantation. The country has a socialised medical
system that allows for full coverage of the assessment for, and completion of
liver transplants in suitable recipients. Between February 1998 and December
2014, the New Zealand Liver Transplant Unit (NZLTU) had performed 595 liver
transplants in 568 patients, indicating a crude re-transplant rate of 4.8%.
Overall 1, 5, and 10 year patient survival rates for all adult (96%, 89%, and
81%, respectively) and pediatric (93%, 92%, and 92%, respectively) recipients
compare very favourably with international outcomes from Europe and the United
States. Eligibility criteria could be modestly expanded if deceased donor rates
improved from the current level of around 10 per million of population per
year. This somewhat meagre supply of deceased donor organs, along with
significant waiting list attrition, has necessitated the use of living donors,
which have been used in more than 50 recipients to date. Despite these
limitations, the NZLTU has contributed to improvements in the outcome of
transplantation for HBV and hepatitis C through the development of effective
antiviral prophylaxis regimes. Furthermore, innovative changes have been made
to the manner in which pediatric patients are transitioned to the adult
service.
The New Zealand Liver Transplant Unit: Auckland District Health Board
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