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Impact of Italian Score for Organ Allocation System on Deceased Donor Liver Transplantation: A Monocentric Competing Risk Time-to-Event Analysis.
- Source :
-
Transplantation proceedings [Transplant Proc] 2019 Nov; Vol. 51 (9), pp. 2860-2864. - Publication Year :
- 2019
-
Abstract
- Background: Liver transplantation (LT) is the only definitive and curative treatment for patients with end-stage liver disease and hepatocellular carcinoma. We aimed to evaluate the impact of the Italian score for organ allocation (ISO) in terms of the waiting-list mortality, probability of LT, and patient survival after LT.<br />Patient and Methods: All of the adult patients on the waiting list for LT at our institute from January 2014 to December 2017 were included in the study. The probabilities of death while on the waiting list, dropout from the list, and LT were compared by means of cumulative incidence functions, in a competing risk time-to-event analysis setting. Uni- and multivariable logistic regression models were used to estimate and compare the probability of death and to find potential risk factors for waiting-list death.<br />Results: There were 286 patients on the waiting list for LT during the study period, 122 of whom entered the waiting list prior to the implementation of ISO (Group A) and 164 afterward (Group B). Group A had 62 transplants, and Group B had 116 transplants. Group B showed a lesser probability of death (P = .005) and a greater probability of transplant (P < .001) compared to Group A. In the 2 groups, post-transplant survival was similar.<br />Conclusion: Based on preliminary clinical experience from a single transplant center, the ISO allocation system demonstrated an overall reduced probability of patient death while on the waiting list without impairing post-LT survival, suggesting that the ISO system might represent an improved method of organ allocation, with a more beneficial distribution of livers.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Carcinoma, Hepatocellular mortality
Carcinoma, Hepatocellular surgery
End Stage Liver Disease mortality
End Stage Liver Disease surgery
Female
Humans
Italy
Liver Neoplasms mortality
Liver Neoplasms surgery
Male
Middle Aged
Retrospective Studies
Risk Factors
Time Factors
Liver Transplantation
Severity of Illness Index
Waiting Lists mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2623
- Volume :
- 51
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 31711575
- Full Text :
- https://doi.org/10.1016/j.transproceed.2019.02.073