Life expectancy without a transplant for status 1A liver transplant candidates.

Autor: Wood NL; Department of Mathematics, United States Naval Academy, Annapolis, Maryland, USA., VanDerwerken DN; Department of Mathematics, United States Naval Academy, Annapolis, Maryland, USA., King EA; Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA., Segev DL; Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA., Gentry SE; Department of Mathematics, United States Naval Academy, Annapolis, Maryland, USA.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2022 Jan; Vol. 22 (1), pp. 274-278. Date of Electronic Publication: 2021 Sep 15.
DOI: 10.1111/ajt.16830
Abstrakt: Status 1A liver transplant candidates are given the highest medical priority for the allocation of deceased donor livers. Organ Procurement and Transplantation Network (OPTN) policy requires physicians to certify that a candidate has a life expectancy without a transplant of less than 7 days for that candidate to be given status 1A. Additionally, candidates receiving status 1A must have one of six medical conditions listed in policy. Using Scientific Registry of Transplant Recipients data from all prevalent liver transplant candidates from 2010 to 2020, we used a bias-corrected Kaplan-Meier model to calculate the survival of status 1A candidates and to determine their life expectancy without a transplant. We found that status 1A candidates have a life expectancy without a transplant of 24 (95% CI 20-46) days-over three times longer than what policy requires for status 1A designation. We repeated the analysis for subgroups of status 1A candidates based on the medical conditions that grant status 1A. We found that none of these subgroups met the life expectancy requirement. Harmonizing OPTN policy with observed data would sustain the integrity of the allocation process.
(© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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