Disparities in the Use of Older Donation After Circulatory Death Liver Allografts in the United States Versus the United Kingdom

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Giorgakis, EmmanouilUniv Arkansas Med Sci, Dept Surg, Div Transplantat, 4301 W Markham St, Little Rock, AR 72205 USA.;Univ Arkansas Med Sci, Rockefeller Canc Inst, Dept Surg Oncol, Hepatopancreatobiliary Surg, Little Rock, AR 72205 USA.;Kings Coll Hosp London, Inst Liver Studies, Liver Transplant, London, England. (författare)

Disparities in the Use of Older Donation After Circulatory Death Liver Allografts in the United States Versus the United Kingdom

Artikel/kapitelEngelska2022

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Lippincott Williams & Wilkins,2022
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LIBRIS-ID:oai:DiVA.org:uu-481587
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-481587URI
https://doi.org/10.1097/TP.0000000000004185DOI

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Språk:engelska
Sammanfattning på:engelska

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Background. This study aimed to assess the differences between the United States and the United Kingdom in the characteristics and posttransplant survival of patients who received donation after circulatory death (DCD) liver allografts from donors aged >60 y. Methods. Data were collected from the UK Transplant Registry and the United Network for Organ Sharing databases. Cohorts were dichotomized into donor age subgroups (donor >60 y [D >60]; donor <= 60 y [D <= 60]). Study period: January 1, 2001, to December 31, 2015. Results. 1157 DCD LTs were performed in the United Kingdom versus 3394 in the United States. Only 13.8% of US DCD donors were aged >50 y, contrary to 44.3% in the United Kingdom. D >60 were 22.6% in the United Kingdom versus 2.4% in the United States. In the United Kingdom, 64.2% of D >60 clustered in 2 metropolitan centers. In the United States, there was marked inter-regional variation. A total of 78.3% of the US DCD allografts were used locally. One- and 5-y unadjusted DCD graft survival was higher in the United Kingdom versus the United States (87.3% versus 81.4%, and 78.0% versus 71.3%, respectively; P < 0.001). One- and 5-y D >60 graft survival was higher in the United Kingdom (87.3% versus 68.1%, and 77.9% versus 51.4%, United Kingdom versus United States, respectively; P < 0.001). In both groups, grafts from donors <= 30 y had the best survival. Survival was similar for donors aged 41 to 50 versus 51 to 60 in both cohorts. Conclusions. Compared with the United Kingdom, older DCD LT utilization remained low in the United States, with worse D >60 survival. Nonetheless, present data indicate similar survivals for older donors aged <= 60, supporting an extension to the current US DCD age cutoff.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng

Biuppslag (personer, institutioner, konferenser, titlar ...)

Ivanics, TommyUppsala universitet,Gastrointestinalkirurgi,Univ Toronto, Univ Hlth Network, Toronto Gen Hosp, Div Gen Surg,Multiorgan Transplant Program, Toronto, ON, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI 48202 USA(Swepub:uu)tomiv601 (författare)
Khorsandi, Shirin E.Kings Coll Hosp London, Inst Liver Studies, Liver Transplant, London, England.;Kings Coll London, Fac Life Sci & Med, London, England. (författare)
Wallace, DavidKings Coll Hosp London, Inst Liver Studies, Liver Transplant, London, England.;Kings Coll London, Fac Life Sci & Med, London, England.;London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England. (författare)
Burdine, LyleUniv Arkansas Med Sci, Dept Surg, Div Transplantat, 4301 W Markham St, Little Rock, AR 72205 USA.;Univ Arkansas Med Sci, Rockefeller Canc Inst, Dept Surg Oncol, Hepatopancreatobiliary Surg, Little Rock, AR 72205 USA. (författare)
Jassem, WayelKings Coll Hosp London, Inst Liver Studies, Liver Transplant, London, England. (författare)
Mathur, Amit K.Mayo Clin, Dept Surg, Div Transplantat, Phoenix, AZ USA. (författare)
Heaton, NigelKings Coll Hosp London, Inst Liver Studies, Liver Transplant, London, England. (författare)
Univ Arkansas Med Sci, Dept Surg, Div Transplantat, 4301 W Markham St, Little Rock, AR 72205 USA.;Univ Arkansas Med Sci, Rockefeller Canc Inst, Dept Surg Oncol, Hepatopancreatobiliary Surg, Little Rock, AR 72205 USA.;Kings Coll Hosp London, Inst Liver Studies, Liver Transplant, London, England.Gastrointestinalkirurgi (creator_code:org_t)

Sammanhörande titlar

Ingår i:Transplantation: Lippincott Williams & Wilkins106:8, s. E358-E3670041-13371534-6080

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Av författaren/redakt...: Giorgakis, Emman ...; Ivanics, Tommy; Khorsandi, Shiri ...; Wallace, David; Burdine, Lyle; Jassem, Wayel; visa fler...; Mathur, Amit K.; Heaton, Nigel; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

Artiklar i publikationen: Transplantation

Av lärosätet: Uppsala universitet

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