Are hepatocellular carcinoma patients more likely to receive liver resection in regions with longer transplant wait times?

J E Anderson; A W Hemming; D C Chang; M A Talamini; K L Mekeel

doi:10.1016/j.transproceed.2013.09.033

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Are hepatocellular carcinoma patients more likely to receive liver resection in regions with longer transplant wait times?

Journal article

Peer reviewed

Are hepatocellular carcinoma patients more likely to receive liver resection in regions with longer transplant wait times?

J E Anderson, A W Hemming, D C Chang, M A Talamini and K L Mekeel

Transplantation proceedings, Vol.46(1), pp.199-201

01/2014

DOI: 10.1016/j.transproceed.2013.09.033

PMID: 24507051

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Abstract

In areas with longer liver transplantation (LT) wait times, liver resection (LR) offers an appropriate alternative in selected patients with hepatocellular carcinoma (HCC). We identified adults with HCC undergoing LT or LR from the United States Nationwide Inpatient Sample from 1998-2008. United Network for Organ Sharing regions were assigned lower rank indicating shorter wait time for patients with Model for End-Stage Liver Disease (MELD) scores of 19-24 or ≥ 25. We used multivariate adjusted analysis to assess the odds of LR versus LT comparing patients by region. Of 4,516 patients, 40% received LT and 60% received LR. When ranked by wait times for MELD 19-24, the 3rd, 8th, and 11th ranked regions had decreased odds of LR versus LT (region 3: odds ratio [OR] 0.3, 95% confidence interval [CI] 0.2-0.6; region 8: OR 0.5, 95% CI 0.3-0.9; region 5: OR 0.3, 95% CI 0.2-0.6), whereas the 10th ranked region had increased odds (region 1: OR 1.9, 95% CI 1.1-3.4) compared with the region with the shortest wait time, region 10. When ranked by wait times for MELD ≥25, all regions except the 10th ranked region (region 5) had increased odds compared with the region with the shortest wait time, region 3 (OR 1.6-5.6; P < .001). Regional variations of LT versus LR are not completely explained by transplant wait times.

Carcinoma, Hepatocellular - surgery

End Stage Liver Disease

Female

Geography

Humans

Liver Neoplasms - surgery

Liver Transplantation - methods

Liver Transplantation - statistics & numerical data

Male

Middle Aged

Multivariate Analysis

Patient Selection

Regression Analysis

Retrospective Studies

Severity of Illness Index

Time Factors

Treatment Outcome

United States

Waiting Lists

Details

Title: Subtitle: Are hepatocellular carcinoma patients more likely to receive liver resection in regions with longer transplant wait times?
Creators: J E Anderson - University of California, San Diego
A W Hemming - University of California, San Diego
D C Chang - University of California, San Diego
M A Talamini - University of California, San Diego
K L Mekeel - University of California, San Diego
Resource Type: Journal article
Publication Details: Transplantation proceedings, Vol.46(1), pp.199-201
DOI: 10.1016/j.transproceed.2013.09.033
PMID: 24507051
ISSN: 0041-1345
eISSN: 1873-2623
Language: English
Date published: 01/2014
Academic Unit: Surgery
Record Identifier: 9984322824802771

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