Liver Transplantation in Japan: Registry by the Japanese Liver Transplantation Society.

As of December 31, 2023, a total of 11,731 liver transplants were performed in 70 institutions in Japan. There were 922 deceased donor transplants (919 from heart-beating donors and 3 from non-heart-beating donors) and 10,809 living-donor transplants. The annual total of liver transplants in 2023 was 470. Deceased-donor transplants increased to 118 in 2023 from 86 in 2022. The most frequent indication was cholestatic disease, followed by hepatocellular disease and neoplastic disease. As for hepatocellular disease in 2023, alcoholic cirrhosis and non-alcoholic steatohepatitis were the most common. Five patients underwent so-called dual graft living-donor liver transplantation (1 in 2001, 1 in 2006, and 3 in 2023). Patient survival following transplantation from heart-beating donors (919 transplants: 1-year 89.1%, 3-year 86.8%, 5-year 84.0%, 10-year 76.6%, 15-year 68.9%, and 20-year 57.7%) was similar to that from living-donors (10,809 transplants: 1-year 86.1%, 3-year 82.4%, 5-year 80.0%, 10-year 75.0%, 15-year 70.1%, 20-year 65.3%, 25-year 61.9%, and 30-year 59.5%). Graft survival was very much the same as patient survival (heart-beating donor: 1-year 88.5%, 3-year 86.1%, 5-year 83.2%, 10-year 75.8%, 15-year 68.2%, and 20-year 53.8% and living-donor: 1-year 85.5%, 3-year 81.5%, 5-year 78.9%, 10-year 73.3%, 15-year 68.0%, 20-year 62.8%, 25-year 59.3%, and 30-year 56.7%). Survival data are reported according to age and sex of recipient, indication, graft type, age and sex of donor, ABO-compatibility, and other factors. Cause of death of living liver donors is also reported.