Low utilization of adult-to-adult LDLT in Western countries despite excellent outcomes

Autor: Tommy Ivanics, David Wallace, Marco P.A.W. Claasen, Madhukar S. Patel, Rushin Brahmbhatt, Chaya Shwaartz, Andreas Prachalias, Parthi Srinivasan, Wayel Jassem, Nigel Heaton, Mark S. Cattral, Nazia Selzner, Anand Ghanekar, Gabriela Morgenshtern, Neil Mehta, Allan B. Massie, Jan van der Meulen, Dorry L. Segev, Gonzalo Sapisochin
Přispěvatelé: Surgery
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Hepatology, 77(6), 1607-1618. Elsevier
ISSN: 1600-0641
0168-8278
Popis: Background & Aims: Adult-to-adult living donor liver transplantation (LDLT) offers an opportunity to decrease the liver transplant waitlist and reduce waitlist mortality. We sought to compare donor and recipient characteristics and post-transplant outcomes after LDLT in the US, the UK, and Canada. Methods: This is a retrospective multicenter cohort-study of adults (≥18-years) who underwent primary LDLT between Jan-2008 and Dec-2018 from three national liver transplantation registries: United Network for Organ Sharing (US), National Health Service Blood and Transplantation (UK), and the Canadian Organ Replacement Registry (Canada). Patients undergoing retransplantation or multi-organ transplantation were excluded. Post-transplant survival was evaluated using the Kaplan-Meier method, and multivariable adjustments were performed using Cox proportional-hazards models with mixed-effect modeling. Results: A total of 2,954 living donor liver transplants were performed (US: n = 2,328; Canada: n = 529; UK: n = 97). Canada has maintained the highest proportion of LDLT utilization over time (proportion of LDLT in 2008 – US: 3.3%; Canada: 19.5%; UK: 1.7%; p
Databáze: OpenAIRE
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