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Outcomes after live...
Outcomes after liver transplantation using deceased after circulatory death donors : A comparison of outcomes in the UK and the US
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- Ivanics, Tommy (författare)
- Uppsala universitet,Gastrointestinalkirurgi,Univ Toronto, Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI USA.
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- Claasen, Marco P. A. W. (författare)
- Univ Toronto, Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Med Ctr Rotterdam, Erasmus MC Transplant Inst, Dept Surg, Div HPB & Transplant Surg, Rotterdam, Netherlands.
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- Patel, Madhukar S. S. (författare)
- Univ Texas Southwestern Med Ctr, Div Surg Transplantat, Dept Surg, Dallas, TX USA.
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- Giorgakis, Emmanouil (författare)
- Univ Arkansas Med Sci, Dept Surg, Div Transplantat, Little Rock, AR USA.;Univ Arkansas Med Sci, Rockefeller Canc Ctr Inst, Dept Surg Oncol, Hepatopancreatobiliary Surg, Little Rock, AR USA.;Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.
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- Khorsandi, Shirin E. E. (författare)
- Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.;Fdn Liver Res, Roger Williams Inst Hepatol, London, England.;Kings Coll London, Fac Life Sci & Med, London, England.
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- Srinivasan, Parthi (författare)
- Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.
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- Prachalias, Andreas (författare)
- Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.
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- Menon, Krishna (författare)
- Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.
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- Jassem, Wayel (författare)
- Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.
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- Cortes, Miriam (författare)
- Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.
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Sayed, Blayne A. A. (författare)
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- Mathur, Amit K. K. (författare)
- Mayo Clin, Dept Surg, Div Transplantat, Phoenix, AZ USA.
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- Walker, Kate (författare)
- London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.
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- Taylor, Rhiannon (författare)
- London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.;Natl Hlth Serv Blood & Transplant, Dept Stat, Bristol, England.
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- Heaton, Nigel (författare)
- Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.
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- Mehta, Neil (författare)
- Univ Calif San Francisco, Dept Med, Div Gastroenterol, San Francisco, CA USA.
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- Segev, Dorry L. L. (författare)
- Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA.;Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD USA.;NYU Grossman Sch Med, Dept Surg, New York, NY USA.;NYU Langone Hlth, New York, NY USA.
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- Massie, Allan B. B. (författare)
- Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA.;Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD USA.;NYU Grossman Sch Med, Dept Surg, New York, NY USA.;NYU Langone Hlth, New York, NY USA.
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- van Der Meulen, Jan H. P. (författare)
- London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.
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- Sapisochin, Gonzalo (författare)
- Univ Toronto, Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.
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- Wallace, David (författare)
- Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.;London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.
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(creator_code:org_t)
- 2023-02-16
- 2023
- Engelska.
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Ingår i: Liver international. - : Wiley-Blackwell. - 1478-3223 .- 1478-3231. ; 43:5, s. 1107-1119
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background and Aims: Identifying international differences in utilization and outcomes of liver transplantation (LT) after donation after circulatory death (DCD) donation provides a unique opportunity for benchmarking and population-level insight.Methods: Adult (>= 18 years) LT data between 2008 and 2018 from the UK and US were used to assess mortality and graft failure after DCD LT. We used time-dependent Cox-regression methods to estimate hazard ratios (HR) for risk-adjusted short-term (0-90 days) and longer-term (90 days-5 years) outcomes.Results: One-thousand five-hundred-and-sixty LT receipts from the UK and 3426 from the US were included. Over the study period, the use of DCD livers increased from 15.7% to 23.9% in the UK compared to 5.1% to 7.6% in the US. In the UK, DCD donors were older (UK:51 vs. US:33 years) with longer cold ischaemia time (UK: 437 vs. US: 333 min). Recipients in the US had higher Model for End-stage Liver Disease (MELD) scores, higher body mass index, higher proportions of ascites, encephalopathy, diabetes and previous abdominal surgeries. No difference in the risk-adjusted short-term mortality or graft failure was observed between the countries. In the longer-term (90 days-5 years), the UK had lower mortality and graft failure (adj.mortality HR:UK: 0.63 (95% CI: 0.49-0.80); graft failure HR: UK: 0.72, 95% CI: 0.58-0.91). The cumulative incidence of retransplantation was higher in the UK (5 years: UK: 11.9% vs. 4.6%; p < .001).Conclusions: For those receiving a DCD LT, longer-term post-transplant outcomes in the UK are superior to the US, however, significant differences in recipient illness, graft quality and access to retransplantation were seen between the two countries.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- liver transplant
- NHSBT
- outcomes
- UNOS
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Ivanics, Tommy
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Claasen, Marco P ...
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Patel, Madhukar ...
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Giorgakis, Emman ...
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Khorsandi, Shiri ...
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Srinivasan, Part ...
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Prachalias, Andr ...
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Menon, Krishna
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Jassem, Wayel
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Cortes, Miriam
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Sayed, Blayne A. ...
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Mathur, Amit K. ...
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Walker, Kate
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Taylor, Rhiannon
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Heaton, Nigel
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Mehta, Neil
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Segev, Dorry L. ...
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Massie, Allan B. ...
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van Der Meulen, ...
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Sapisochin, Gonz ...
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Wallace, David
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Liver internatio ...
- Av lärosätet
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Uppsala universitet