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Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective

Authors :
Pei-Yin Hsieh
M.-H Lin
Ming-Chih Ho
Rey-Heng Hu
Yao-Ming Wu
Cheng-Maw Ho
H.-Y Lin
Po-Huang Lee
Source :
Journal of Personalized Medicine, Volume 11, Issue 11, Journal of Personalized Medicine, Vol 11, Iss 1173, p 1173 (2021)
Publication Year :
2021
Publisher :
Multidisciplinary Digital Publishing Institute, 2021.

Abstract

Background: The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. Methods: In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. Results: From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0–58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0–188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient’s critical illness, donor’s physical conditions, motivation for live donation, and stable condition while on the waiting list. Conclusions: Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process.

Details

Language :
English
ISSN :
20754426
Database :
OpenAIRE
Journal :
Journal of Personalized Medicine
Accession number :
edsair.doi.dedup.....bcf7de87b1749bf45fde44d0d1ea9ecb
Full Text :
https://doi.org/10.3390/jpm11111173