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  • Ivanics, TommyUppsala universitet,Gastrointestinalkirurgi,Univ Toronto, Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI USA. (author)

Outcomes after liver transplantation using deceased after circulatory death donors : A comparison of outcomes in the UK and the US

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023-02-16
  • Wiley-Blackwell,2023
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-512748
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512748URI
  • https://doi.org/10.1111/liv.15537DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Claasen, Marco P. A. W.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. (author)
  • Patel, Madhukar S. S.Univ Texas Southwestern Med Ctr, Div Surg Transplantat, Dept Surg, Dallas, TX USA. (author)
  • Giorgakis, EmmanouilUniv 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. (author)
  • Khorsandi, Shirin E. E.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. (author)
  • Srinivasan, ParthiKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England. (author)
  • Prachalias, AndreasKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England. (author)
  • Menon, KrishnaKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England. (author)
  • Jassem, WayelKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England. (author)
  • Cortes, MiriamKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England. (author)
  • Sayed, Blayne A. A. (author)
  • Mathur, Amit K. K.Mayo Clin, Dept Surg, Div Transplantat, Phoenix, AZ USA. (author)
  • Walker, KateLondon Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England. (author)
  • Taylor, RhiannonLondon Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.;Natl Hlth Serv Blood & Transplant, Dept Stat, Bristol, England. (author)
  • Heaton, NigelKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England. (author)
  • Mehta, NeilUniv Calif San Francisco, Dept Med, Div Gastroenterol, San Francisco, CA USA. (author)
  • Segev, Dorry L. L.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. (author)
  • Massie, Allan B. B.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. (author)
  • van Der Meulen, Jan H. P.London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England. (author)
  • Sapisochin, GonzaloUniv Toronto, Univ Hlth Network, Multiorgan Transplant Program, Toronto, ON, Canada. (author)
  • Wallace, DavidKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England.;London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England. (author)
  • Uppsala universitetGastrointestinalkirurgi (creator_code:org_t)

Related titles

  • In:Liver international: Wiley-Blackwell43:5, s. 1107-11191478-32231478-3231

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