1. Live Donor Liver Transplantation in the United States: Impact of Share 35 on Live Donor Utilization
- Author
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Joshua Grab, Jennifer L. Dodge, Nancy L. Ascher, Hillary J. Braun, Marisa E. Schwab, Peter G. Stock, John P. Roberts, Alexa Glencer, Ryutaro Hirose, and Iris H. Liu
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Live donor ,medicine.medical_treatment ,Chronic Liver Disease and Cirrhosis ,Geographic variation ,030230 surgery ,Liver transplantation ,Medical and Health Sciences ,Risk Assessment ,Severity of Illness Index ,Oral and gastrointestinal ,Article ,Decision Support Techniques ,Donor Selection ,End Stage Liver Disease ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,medicine ,Living Donors ,Humans ,Transplantation ,Deceased donor ,business.industry ,Liver Disease ,Evaluation of treatments and therapeutic interventions ,Patient survival ,Organ Transplantation ,Middle Aged ,medicine.disease ,United States ,Surgery ,Liver Transplantation ,Organ procurement ,Good Health and Well Being ,Treatment Outcome ,030211 gastroenterology & hepatology ,Female ,Digestive Diseases ,business ,6.4 Surgery - Abstract
BACKGROUND Share 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. METHODS Using 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. RESULTS In 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
- Published
- 2020