Living donor liver transplantation improves waitlist outcomes in high-risk cirrhosis patients

NewsGuard 100/100 Score

A new research paper was published in Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 15, Issue 17, entitled, "Availability of living donor optimizes timing of liver transplant in high-risk waitlisted cirrhosis patients."

Liver transplant (LT) candidates have become older and frailer. Growing non-alcoholic steatohepatitis (NASH) and comorbid disease burden in recent years is also predisposing them for poor waitlist outcomes. In this new study, researchers Fakhar Ali Qazi Arisar, Shiyi Chen, Catherine Chen, Noorulsaba Shaikh, Ravikiran Sindhuvalada Karnam, Wei Xu, Sumeet K. Asrani, Zita Galvin, Gideon Hirschfield, Keyur Patel, Cynthia Tsien, Nazia Selzner, Mark Cattral, Leslie Lilly, and Mamatha Bhat from the University Health Network, University of Toronto, Baylor University Medical Center, and Dow University of Health Sciences aimed to evaluate the impact of access to living donor liver transplantation (LDLT) in waitlisted patients at highest risk of dropout.

"We reviewed all adult patients with decompensated cirrhosis listed for LT from November 2012 to December 2018."

Patients with a potential living donor (pLD) available were identified. Survival analyses with Cox Proportional Hazards models and time to LT with Competing risk models were performed followed by prediction model development. Out of 860 patients who met inclusion criteria, 360 (41.8%) had a pLD identified and 496 (57.6%) underwent LT, out of which 170 (34.2%) were LDLT. The benefit of pLD was evident for all, but patients with moderate to severe frailty at listing (interaction p = 0.03), height <160 cm (interaction p = 0.03), and Model for end-stage liver disease (MELD)-Na score <20 (interaction p < 0.0001) especially benefited.

"Our study identifies that certain patient subgroups (short stature, MELD <20, and moderate to severe frailty) are at the highest risk for waitlist mortality with prolonged waiting time for a deceased donor organ offer. These patient subgroups, which represent a growing share of the waitlist population in recent years, would be especially protected against death or delisting if they had access to living donation at the time of listing. Certainly, LDLT is beneficial to all, with improved waitlist mortality and post-transplant outcomes."

Source:
Journal reference:

Qazi, A., et al. (2023). Availability of living donor optimizes timing of liver transplant in high-risk waitlisted cirrhosis patients. Aging. doi.org/10.18632/aging.204982.

Comments

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
Post

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.

You might also like...
Evaluating systemic thrombolysis for acute portal vein thrombosis in cirrhotic patients