Document Detail


Predicted lifetimes for adult and pediatric split liver versus adult whole liver transplant recipients.
MedLine Citation:
PMID:  15476478     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Split liver transplantation allows 2 recipients to receive transplants from one organ. Comparisons of predicted lifetimes for two alternatives (split liver for an adult and pediatric recipient vs. whole liver for an adult recipient) can help guide the use of donor livers. We analyzed mortality risk for 48,888 waitlisted candidates, 907 split and 21,913 whole deceased donor liver transplant recipients between January 1, 1995 and February 26, 2002. Cox regression models for pediatric and adult patients assessed average relative wait list and post-transplant death risks, for split liver recipients. Life years gained compared with remaining on the waiting list over a 2-year period were calculated. Seventy-six splits (152 recipients) and 24 re-transplants resulted from every 100 livers (13.1% [adult] and 18.0% [pediatric] 2-year re-transplant rates, respectively). Whole livers used for 93 adults also utilized 100 livers (re-transplant rate 7.0%). Eleven extra life years and 59 incremental recipients accrued from each 100 livers used for split compared with whole organ transplants. Split liver transplantation could provide enough organs to satisfy the entire current demand for pediatric donor livers in the United States, provide more aggregate years of life than whole organ transplants and result in larger numbers of recipients.
Authors:
Robert M Merion; Sarah H Rush; Dawn M Dykstra; Nathan Goodrich; Richard B Freeman; Robert A Wolfe
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  4     ISSN:  1600-6135     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-12     Completed Date:  2005-03-07     Revised Date:  2007-02-14    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1792-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA. merionb@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Cadaver
Child
Child, Preschool
Female
Follow-Up Studies
Hepatectomy / methods*
Humans
Liver Transplantation / mortality,  physiology*
Male
Middle Aged
Regression Analysis
Reoperation / statistics & numerical data
Retrospective Studies
Survival Analysis
Time Factors
Tissue Donors
Tissue and Organ Harvesting / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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