학술논문

Live Donor Liver Transplantation in the United States: Impact of Share 35 on Live Donor Utilization.
Document Type
article
Source
Transplantation. 105(4)
Subject
Humans
Treatment Outcome
Liver Transplantation
Donor Selection
Severity of Illness Index
Risk Assessment
Risk Factors
Predictive Value of Tests
Decision Support Techniques
Time Factors
Middle Aged
Living Donors
United States
Female
Male
End Stage Liver Disease
Chronic Liver Disease and Cirrhosis
Digestive Diseases
Liver Disease
Transplantation
Organ Transplantation
Evaluation of treatments and therapeutic interventions
6.4 Surgery
Oral and gastrointestinal
Good Health and Well Being
Medical and Health Sciences
Surgery
Language
Abstract
BackgroundShare 35 was a policy implemented in 2013 to increase regional sharing of deceased donor livers to patients with model for end-stage liver disease ≥ 35 to decrease waitlist mortality for the sickest patients awaiting liver transplantation (LT). The purpose of this study was to determine whether live donor liver transplantation (LDLT) volume was impacted by the shift in allocation of deceased donor livers to patients with higher model for end-stage liver disease scores.MethodsUsing Network for Organ Sharing/Organ Procurement and Transplantation Network Standard Transplant Analysis and Research files, we identified all adults who received a primary LT between October 1, 2008, and March 31, 2018. LT from October 1, 2008, through June 30, 2013, was designated as the pre-Share 35 era and July 1, 2013, through March 31, 2018, as the post-Share 35 era. Primary outcomes included transplant volumes, graft survival, and patient survival in both eras.ResultsIn total, 48 779 primary adult single-organ LT occurred during the study period (22 255 pre-Share 35, 26 524 post). LDLT increased significantly (6.8% post versus 5.7% pre, P