| The use of living donor liver transplantation varies with the availability of deceased donor liver transplantation. | |
| | |
MedLine Citation:
|
PMID: 22006378 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: The demographics of patients in the United States, who received living donor liver transplants (LDLT), as opposed to deceased donor liver transplants (DDLT), are of interest in relation to the demographics of the donor service areas (DSA). METHODS: We examined adult recipients of primary, non-Status 1, liver-only transplants, from 2003-2009. The likelihood of receiving a LDLT was compared to DDLT by multivariate logistic regression. We examined the adjusted odds ratio of receiving a LDLT compared to DDLT for patients with the same diagnosis and blood type, after stratifying the DSAs into quintiles by median match MELD score. RESULTS: Of 32,927 liver transplants, 1497 were LDLT (4.6%). LDLT decreased in frequency by 30% from 2003-2009. As compared to DDLT, LDLT recipients were younger, had higher albumin levels, lower BMI, and lower match MELD scores. Females had increased odds of LDLT compared to males (OR=1.74, p<.0001). Patients with MELD exception scores were less likely to receive LDLT (OR=0.22, p<.0001). Patients with cholestatic liver disease, or malignant neoplasms other than hepatocellular carcinoma (HCC), were more likely than patients with Hepatitis C (HCV) to receive LDLT (OR(adj) =2.04, p<.0001; OR(adj) =3.33, p<.0001, respectively). Other characteristics associated with decreased odds of LDLT were black race (OR(adj) =0.41, p<.0001) and government insurance (OR(adj) =0.51, p<.0001). LDLT was more frequent in DSAs with high median MELD scores, with an adjusted OR for LDLT of 38 for the DSAs in the highest quintile (p<.0001). DISCUSSION: There are significant differences associated with race, insurance, gender, MELD exceptions and DSA MELD score between patients who receive a LDLT compared to DDLT. These differences can be hypothesized to be driven in part by the relative availability of LDLT to DDLT on both a patient and DSA level. © 2011 American Association for the Study of Liver Diseases. |
| | |
Authors:
|
Parsia A Vagefi; Nancy L Ascher; Chris E Freise; Jennifer L Dodge; John P Roberts |
Related Documents
:
|
8788278 - Modulation of smooth muscle activity by nitric oxide in the human upper urinary tract. 21681668 - Partial liver transplantation. 21738 - Influence of acetohydroxamic acid on experimental corynebacterium renale pyelonephritis. 21994848 - Early hepatocellular carcinoma: transplantation versus resection: the case for liver re... 16785058 - Improving the efficacy of reduced intensity allogeneic transplantation for lymphoma usi... 17596528 - Isoflurane protects against renal ischemia and reperfusion injury and modulates leukocy... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-10-17 |
Journal Detail:
|
Title: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Volume: - ISSN: 1527-6473 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
|
Created Date: 2011-10-18 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100909185 Medline TA: Liver Transpl Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 American Association for the Study of Liver Diseases. |
Affiliation:
|
Division of Transplant Surgery, University of California, San Francisco, San Francisco, CA 94143, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: CXCR3 promotes the production of IgG1 (auto)antibodies but is not essential for the development of l...
Next Document: High-dose Ambroxol Reduces Pulmonary Complications in Patients with Acute Cervical Spinal Cord Injur...