Liver transplant recipient survival benefit with living donation in the model for endstage liver disease allocation era
dc.contributor.author | Berg, Carl L. | en_US |
dc.contributor.author | Merion, Robert M. | en_US |
dc.contributor.author | Shearon, Tempie H. | en_US |
dc.contributor.author | Olthoff, Kim M. | en_US |
dc.contributor.author | Brown, Robert S. | en_US |
dc.contributor.author | Baker, Talia B. | en_US |
dc.contributor.author | Everson, Gregory T. | en_US |
dc.contributor.author | Hong, Johnny C. | en_US |
dc.contributor.author | Terrault, Norah A. | en_US |
dc.contributor.author | Hayashi, Paul H. | en_US |
dc.contributor.author | Fisher, Robert A. | en_US |
dc.contributor.author | Everhart, James E. | en_US |
dc.date.accessioned | 2011-11-10T15:32:43Z | |
dc.date.available | 2012-12-03T21:17:29Z | en_US |
dc.date.issued | 2011-10 | en_US |
dc.identifier.citation | Berg, Carl L.; Merion, Robert M.; Shearon, Tempie H.; Olthoff, Kim M.; Brown, Robert S.; Baker, Talia B.; Everson, Gregory T.; Hong, Johnny C.; Terrault, Norah; Hayashi, Paul H.; Fisher, Robert A.; Everhart, James E. (2011). "Liver transplant recipient survival benefit with living donation in the model for endstage liver disease allocation era ." Hepatology 54(4): 1313-1321. <http://hdl.handle.net/2027.42/86878> | en_US |
dc.identifier.issn | 0270-9139 | en_US |
dc.identifier.issn | 1527-3350 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/86878 | |
dc.description.abstract | Receipt of a living donor liver transplant (LDLT) has been associated with improved survival compared with waiting for a deceased donor liver transplant (DDLT). However, the survival benefit of liver transplant has been questioned for candidates with Model for Endstage Liver Disease (MELD) scores <15, and the survival advantage of LDLT has not been demonstrated during the MELD allocation era, especially for low MELD patients. Transplant candidates enrolled in the Adult‐to‐Adult Living Donor Liver Transplantation Cohort Study after February 28, 2002 were followed for a median of 4.6 years. Starting at the time of presentation of the first potential living donor, mortality for LDLT recipients was compared to mortality for patients who remained on the waiting list or received DDLT (no LDLT group) according to categories of MELD score (<15 or ≥15) and diagnosis of hepatocellular carcinoma (HCC). Of 868 potential LDLT recipients (453 with MELD <15; 415 with MELD ≥15 at entry), 712 underwent transplantation (406 LDLT; 306 DDLT), 83 died without transplant, and 73 were alive without transplant at last follow‐up. Overall, LDLT recipients had 56% lower mortality (hazard ratio [HR] = 0.44, 95% confidence interval [CI] 0.32‐0.60; P < 0.0001). Among candidates without HCC, mortality benefit was seen both with MELD <15 (HR = 0.39; P = 0.0003) and MELD ≥15 (HR = 0.42; P = 0.0006). Among candidates with HCC, a benefit of LDLT was not seen for MELD <15 (HR = 0.82, P = 0.65) but was seen for MELD ≥15 (HR = 0.29, P = 0.043). Conclusion: Across the range of MELD scores, patients without HCC derived a significant survival benefit when undergoing LDLT rather than waiting for DDLT in the MELD liver allocation era. Low MELD candidates with HCC may not benefit from LDLT. (H EPATOLOGY 2011;54:1313–1321) | en_US |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.title | Liver transplant recipient survival benefit with living donation in the model for endstage liver disease allocation era | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Surgery, University of Michigan and Arbor Research Collaborative for Health, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Department of Biostatistics, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationother | Department of Medicine, University of Virginia Health System, Charlottesville, VA | en_US |
dc.contributor.affiliationother | Department of Surgery, University of Pennsylvania, Philadelphia, PA | en_US |
dc.contributor.affiliationother | Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY | en_US |
dc.contributor.affiliationother | Department of Surgery, Northwestern University, Chicago, IL | en_US |
dc.contributor.affiliationother | Department of Medicine, University of Colorado, Aurora, CO | en_US |
dc.contributor.affiliationother | Department of Surgery, University of California, Los Angeles, Los Angeles, CA | en_US |
dc.contributor.affiliationother | Department of Medicine, University of California, San Francisco, San Francisco, CA | en_US |
dc.contributor.affiliationother | Department of Medicine, University of North Carolina, Chapel Hill, NC | en_US |
dc.contributor.affiliationother | Department of Surgery, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, VA | en_US |
dc.contributor.affiliationother | Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD | en_US |
dc.contributor.affiliationother | University of Virginia Health System, P.O. Box 800708, Charlottesville VA 22908‐0708 | en_US |
dc.identifier.pmid | 21688284 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/86878/1/24494_ftp.pdf | |
dc.identifier.doi | 10.1002/hep.24494 | en_US |
dc.identifier.source | Hepatology | en_US |
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dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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