Offer Acceptance Patterns for Liver Donors Aged 70 and Older
| Autor: | Jacqueline Garonzik-Wang, Christine E. Haugen, Benjamin Philosophe, Karim J. Halazun, Teresa Po-Yu Chiang, Dorry L. Segev, Allan B. Massie, Kyle R. Jackson, Mary G. Bowring |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Tissue and Organ Procurement Waiting Lists medicine.medical_treatment Liver transplantation Rate ratio Severity of Illness Index Article End Stage Liver Disease symbols.namesake Living Donors Medicine Humans Poisson regression Aged Aged 80 and over Transplantation Hepatology business.industry Proportional hazards model Hazard ratio Odds ratio Confidence interval Tissue Donors Liver Transplantation Quartile symbols Surgery business Demography |
| Zdroj: | Liver Transpl |
| Popis: | Despite a documented survival benefit, older liver donor (OLD, age ≥70) graft offers are frequently declined, with utilization worsening over the last decade. To understand how offer acceptance varies by center, we studied 1113 eventually transplanted OLD grafts from 2009 to 2017 using Scientific Registry of Transplant Recipients (SRTR) data and random-intercept multilevel logistic regression. To understand how center-level acceptance of OLD graft offers might be associated with waitlist and posttransplant outcomes, we studied all adult, actively listed, liver-only candidates and recipients during the study period using Poisson regression (transplant rate), competing risks regression (waitlist mortality), and Cox regression (posttransplant mortality). Among 117 centers, OLD offer acceptance ranged from 0 (23 centers) to 95 acceptances, with a median odds ratio of 2.88. Thus, a candidate may be three times as likely to receive an OLD graft simply by listing at a different center. Centers in the highest quartile (Q4) of OLD acceptance (accepted 39% of OLD offers) accepted more nationally shared organs (Q4 versus Q1: 14.1% versus 0.0%, P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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