Geographic variation in liver transplantation persists despite implementation of Share35
| Autor: | Patrick G. Northup, Daniel G. Maluf, Jonathan G. Stine, Shawn J. Pelletier, Curtis K. Argo, George J. Stukenborg, Scott L. Cornella |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Cirrhosis Hepatology business.industry Proportional hazards model medicine.medical_treatment Geographic variation 030230 surgery Liver transplantation medicine.disease Surgery Transplantation 03 medical and health sciences 0302 clinical medicine Infectious Diseases Survival benefit Medicine 030211 gastroenterology & hepatology Adult liver Waitlist mortality business Demography |
| Zdroj: | Hepatology Research. 48:225-232 |
| ISSN: | 1386-6346 |
| Popis: | Aim Geographic disparities persist in the U.S. despite locoregional organ sharing policies. The impact of national organ sharing policies on waiting-list mortality on a regional basis remains unknown. Methods Data on all adult liver transplants between February 1, 2002 and March 31, 2015 were obtained from UNOS/OPTN. Multivariable Cox proportional hazards models were constructed in a time-to-event analysis to estimate waiting-list mortality for the pre- and post-Share35 eras. Results 134,247 patients were listed for transplantation and 54,510 received organs (42.8%). Listing volume increased following Share35 (15,976 candidates pre- vs. 18,375 post) without significant regional changes as did number of transplants (7,210 pre- vs. 8,224 post). Waiting-list mortality improved from 12.2% to 8.1% (p35 candidates. The disparities highlighted by our findings imply a need to review current allocation policies to best balance local, regional, and national transplant environments. |
| Databáze: | OpenAIRE |
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