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Waitlist Outcomes of Liver Transplant Candidates Who Were Reprioritized Under Share 35
| Content Provider | Scilit |
|---|---|
| Author | Chow, E. K. H. Massie, A. B. Luo, X. Wickliffe, C. E. Gentry, S. E. Cameron, A. M. Segev, D. L. |
| Copyright Year | 2016 |
| Description | Journal: American Journal of Transplantation Under Share 35, deceased donor (DD) livers are offered regionally to candidates with Model for End-Stage Liver Disease (MELD) scores ≥35 before being offered locally to candidates with MELD scores <35. Using Scientific Registry of Transplant Recipients data from June 2013 to June 2015, we identified 1768 DD livers exported to regional candidates with MELD scores ≥35 who were transplanted at a median MELD score of 39 (interquartile range [IQR] 37-40) with 30-day posttransplant survival of 96%. In total, 1764 (99.8%) exports had an ABO-compatible candidate in the recovering organ procurement organization (OPO), representing 1219 unique reprioritized candidates who would have had priority over the regional candidate under pre-Share 35 allocation. Reprioritized candidates had a median waitlist MELD score of 31 (IQR 27-34) when the liver was exported. Overall, 291 (24%) reprioritized candidates had a comparable MELD score (within 3 points of the regional recipient), and 209 (72%) were eventually transplanted in 11 days (IQR 3-38 days) using a local (50%), regional (50%) or national (<1%) liver; 60 (21%) died, 13 (4.5%) remained on the waitlist and nine (3.1%) were removed for other reasons. Of those eventually transplanted, MELD score did not increase in 57%; it increased by 1-3 points in 37% and by ≥4 points in 5.7% after the export. In three cases, OPOs exchanged regional exports within a 24-h window. The majority of comparable reprioritized candidates were not disadvantaged; however, 21% died after an export. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433796/pdf |
| Ending Page | 518 |
| Page Count | 7 |
| Starting Page | 512 |
| e-ISSN | 16006143 |
| DOI | 10.1111/ajt.13980 |
| Journal | American Journal of Transplantation |
| Issue Number | 2 |
| Volume Number | 17 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2016-08-24 |
| Access Restriction | Open |
| Subject Keyword | Journal: American Journal of Transplantation Health Services and Outcomes Research Liver Transplantation/hepatology Organ Procurement and Allocation |
| Content Type | Text |
| Resource Type | Article |
