Sökning: id:"swepub:oai:DiVA.org:uu-495414" >
Low utilization of ...
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Ivanics, TommyUppsala universitet,Gastrointestinalkirurgi,Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI USA.;Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA.
(författare)
Low utilization of adult-to-adult LDLT in Western countries despite excellent outcomes : International multicenter analysis of the US, the UK, and Canada
- Artikel/kapitelEngelska2022
Förlag, utgivningsår, omfång ...
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Elsevier,2022
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-495414
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-495414URI
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https://doi.org/10.1016/j.jhep.2022.07.035DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:art swepub-publicationtype
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Background & Aims: Adult-to-adult living donor liver trans-plantation (LDLT) offers an opportunity to decrease the liver transplant waitlist and reduce waitlist mortality. We sought to compare donor and recipient characteristics and post-transplant outcomes after LDLT in the US, the UK, and Canada.Methods: This is a retrospective multicenter cohort-study of adults (>-18-years) who underwent primary LDLT between Jan -20 08 and Dec-2018 from three national liver transplantation registries: United Network for Organ Sharing (US), National Health Service Blood and Transplantation (UK), and the Canadian Organ Replacement Registry (Canada). Patients undergoing retransplantation or multi-organ transplantation were excluded. Post-transplant survival was evaluated using the Kaplan-Meier method, and multivariable adjustments were performed using Cox proportional-hazards models with mixed-effect modeling.Results: A total of 2,954 living donor liver transplants were performed (US: n = 2,328; Canada: n = 529; UK: n = 97). Canada has maintained the highest proportion of LDLT utilization over time (proportion of LDLT in 2008 - US: 3.3%; Canada: 19.5%; UK: 1.7%; p <0.001 - in 2018 - US: 5.0%; Canada: 13.6%; UK: 0.4%; p <0.001). The 1-, 5-, and 10-year patient survival was 92.6%, 82.8%, and 70.0% in the US vs. 96.1%, 89.9%, and 82.2% in Canada vs. 91.4%, 85.4%, and 66.7% in the UK. After adjustment for charac-teristics of donors, recipients, transplant year, and treating transplant center as a random effect, all countries had a non -statistically significantly different mortality hazard post-LDLT (Ref US: Canada hazard ratio 0.53, 95% CI 0.28-1.01, p = 0.05; UK hazard ratio 1.09, 95% CI 0.59-2.02, p = 0.78).Conclusions: The use of LDLT has remained low in the US, the UK and Canada. Despite this, long-term survival is excellent. Continued efforts to increase LDLT utilization in these countries may be warranted due to the growing waitlist and differences in allocation that may disadvantage patients currently awaiting liver transplantation.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Wallace, DavidLondon Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.;Kings Coll Hosp London, Inst Liver Studies, Denmark Hill, London, England.
(författare)
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Claasen, Marco P. A. W.Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Med Ctr Rotterdam, Dept Surg, Erasmus MC, Rotterdam, Netherlands.
(författare)
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Patel, Madhukar S.Univ Texas Southwestern Med Ctr, Dept Surg, Div Surg Transplantat, Dallas, TX USA.
(författare)
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Brahmbhatt, RushinUniv Hlth Network, Div Gen Surg, Toronto, ON, Canada.
(författare)
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Shwaartz, ChayaUniv Hlth Network, Div Gen Surg, Toronto, ON, Canada.
(författare)
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Prachalias, AndreasKings Coll Hosp London, Inst Liver Studies, Denmark Hill, London, England.
(författare)
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Srinivasan, ParthiKings Coll Hosp London, Inst Liver Studies, Denmark Hill, London, England.
(författare)
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Jassem, WayelKings Coll Hosp London, Inst Liver Studies, Denmark Hill, London, England.
(författare)
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Heaton, NigelKings Coll Hosp London, Inst Liver Studies, Denmark Hill, London, England.
(författare)
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Cattral, Mark S.Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
(författare)
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Selzner, NaziaUniv Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
(författare)
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Ghanekar, AnandUniv Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
(författare)
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Morgenshtern, GabrielaUniv Toronto, Dept Comp Sci, Toronto, ON, Canada.;Hosp Sick Children, Genet & Genome Biol, Toronto, ON, Canada.;Vector Inst, Toronto, ON, Canada.
(författare)
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Mehta, NeilUniv Calif San Francisco, Dept Med, Div Gastroenterol, San Francisco, CA USA.
(författare)
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Massie, Allan B.Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA.;Johns Hopkins Univ, Dept Surg, Sch Med, Baltimore, MD USA.;NYU, Dept Surg, Grossman Sch Med, New York, NY USA.
(författare)
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van der Meulen, JanLondon Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.
(författare)
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Segev, Dorry L.Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA.;Johns Hopkins Univ, Dept Surg, Sch Med, Baltimore, MD USA.;NYU, Dept Surg, Grossman Sch Med, New York, NY USA.
(författare)
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Sapisochin, GonzaloUniv Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Hlth Network, Div Gen Surg, Toronto, ON, Canada.;Univ Hlth Network, HBP & Multiorgan Transplant Program, Div Gen Surg, 585 Univ Ave,11PMB184, Toronto, ON M5G 2N2, Canada.
(författare)
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Uppsala universitetGastrointestinalkirurgi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Journal of Hepatology: Elsevier77:6, s. 1607-16180168-82781600-0641
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- Av författaren/redakt...
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Ivanics, Tommy
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Wallace, David
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Claasen, Marco P ...
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Patel, Madhukar ...
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Brahmbhatt, Rush ...
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Shwaartz, Chaya
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visa fler...
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Prachalias, Andr ...
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Srinivasan, Part ...
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Jassem, Wayel
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Heaton, Nigel
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Cattral, Mark S.
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Selzner, Nazia
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Ghanekar, Anand
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Morgenshtern, Ga ...
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Mehta, Neil
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Massie, Allan B.
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van der Meulen, ...
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Segev, Dorry L.
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Sapisochin, Gonz ...
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