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Impact of the acuit...
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Ivanics, TommyUppsala universitet,Gastrointestinalkirurgi,Division of Transplant and Hepatobiliary Surgery Henry Ford Hospital Michigan USA.
(författare)
Impact of the acuity circle model for liver allocation on multivisceral transplant candidates
- Artikel/kapitelEngelska2022
Förlag, utgivningsår, omfång ...
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John Wiley & Sons,2022
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LIBRIS-ID:oai:DiVA.org:uu-457977
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-457977URI
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https://doi.org/10.1111/ajt.16803DOI
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Språk:engelska
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Sammanfattning på:engelska
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Liver allocation was updated on February 4, 2020, replacing a Donor Service Area (DSA) with acuity circles (AC). The impact on waitlist outcomes for patients listed for combined liver-intestine transplantation (multivisceral transplantation [MVT]) remains unknown. The Organ Procurement and Transplantation Network/United Network for Organ Sharing database was used to identify all candidates listed for both liver and intestine between January 1, 2018 and March 5, 2021. Two eras were defined: pre-AC (2018–2020) and post-AC (2020–2021). Outcomes included 90-day waitlist mortality and transplant probability. A total of 127 adult and 104 pediatric MVT listings were identified. In adults, the 90-day waitlist mortality was not statistically significantly different, but transplant probability was lower post-AC. After risk-adjustment, post-AC was associated with a higher albeit not statistically significantly different mortality hazard (sub-distribution hazard ratio[sHR]: 8.45, 95% CI: 0.96–74.05; p = .054), but a significantly lower transplant probability (sHR: 0.33, 95% CI: 0.15–0.75; p = .008). For pediatric patients, waitlist mortality and transplant probability were similar between eras. The proportion of patients who underwent transplant with exception points was lower post-AC both in adult (44% to 9%; p = .04) and pediatric recipients (65% to 15%; p = .002). A lower transplant probability observed in adults listed for MVT may ultimately result in increased waitlist mortality. Efforts should be taken to ensure equitable organ allocation in this vulnerable patient population.
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Vianna, RodrigoDivision of Liver/GI Transplant Department of Surgery Miami Transplant InstituteJackson Memorial Hospital/University of Miami Miami Florida USA
(författare)
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Kubal, Chandrashekhar A.Division of Abdominal Transplant Surgery Department of Surgery Indiana University School of Medicine Indianapolis Indiana USA
(författare)
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Iyer, Kishore R.Recanati‐Miller Transplantation InstituteMount Sinai Hospital New York New York USA
(författare)
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Mazariegos, George V.Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of Pittsburgh Pittsburgh Pennsylvania USA
(författare)
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Matsumoto, Cal S.Medstar Georgetown University HospitalMedstar Georgetown Transplant Institute Washington DC USA
(författare)
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Mangus, RichardDivision of Abdominal Transplant Surgery Department of Surgery Indiana University School of Medicine Indianapolis Indiana USA
(författare)
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Beduschi, ThiagoDivision of Transplantation and Hepatobiliary Surgery Department of Surgery University of Florida Gainesville Florida USA
(författare)
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Abouljoud, MarwanDivision of Transplant and Hepatobiliary Surgery Henry Ford Hospital Michigan USA
(författare)
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Fridell, Jonathan A.Division of Abdominal Transplant Surgery Department of Surgery Indiana University School of Medicine Indianapolis Indiana USA
(författare)
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Nagai, ShunjiDivision of Transplant and Hepatobiliary Surgery Henry Ford Hospital Michigan USA
(författare)
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Uppsala universitetGastrointestinalkirurgi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:American Journal of Transplantation: John Wiley & Sons22:2, s. 464-4731600-61351600-6143
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Ivanics, Tommy
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Vianna, Rodrigo
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Kubal, Chandrash ...
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Iyer, Kishore R.
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Mazariegos, Geor ...
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Matsumoto, Cal S ...
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Mangus, Richard
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Beduschi, Thiago
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Abouljoud, Marwa ...
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Fridell, Jonatha ...
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Nagai, Shunji
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