As of December 31, 2021, a total of 10,839 liver transplants had been performed in 70 institutions in Japan. There were 718 deceased donor transplants (715 from heart-beating donors and 3 from non-heart-beating donors) and 10,121 living-donor transplants. The annual total of liver transplants in 2021 was 421. Deceased-donor transplants decreased to 63 in 2020 and 60 in 2021 from 88 in 2019, probably due to the COVID-19 pandemic. The most frequent indication was cholestatic disease, followed by hepatocellular disease and neoplastic disease. As for hepatocellular disease in 2021, alcoholic cirrhosis and non-alcoholic steatohepatitis were the most common. Patient survival following transplantation from heart-beating donors (715 transplants: 1-year 88.9%, 3-year 86.3%, 5-year 82.9%, 10-year 76.1%, 15-year 68.3%, 20-year 57.8%) was similar to that from living-donors (10,121 transplants: 1-year 85.7%, 3-year 81.9%, 5-year 79.4%, 10-year 74.4%, 15-year 69.7%, 20-year 65.2%, 25-year 62.3%, 30-year 58.8%). Graft survival was very much the same as patient survival (heart-beating donor: 1-year 88.5%, 3-year 85.9%, 5-year 82.5%, 10-year 75.7%, 15-year 67.9%, 20-year 57.5%,living-donor: 1-year 85.1%, 3-year 80.9%, 5-year 78.3%, 10-year 72.7%, 15-year 67.6%, 20-year 62.6%, 25-year 59.5%, 30-year 55.4%). 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.
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