Journal article
Regional differences in deceased donor liver transplantation and their implications for organ utilization and allocation
Clinical transplantation, Vol.25(1), pp.156-163
01/01/2011
DOI: 10.1111/j.1399-0012.2010.01214.x
PMID: 20156220
Abstract
We examined the UNOS database from 7/15/00-7/17/05 for Regional deceased donor liver utilization. For each region, we performed logistic regression and derived odds ratios (OR) for donor characteristics associated with livers being transplanted outside of the region or not transplanted at all. Regions with smallest and least significant OR were considered aggressive users of suboptimal organs. We estimated how many untransplanted livers from less aggressive regions might be used by more aggressive regions. Only Region 9 was significantly more aggressive than others (median OR: 6 vs. 16; p < 0.01; median OR size: 1.4 vs. 3.6; p < 0.01). Region 9 transplanted at higher median Model for End-stage Liver Disease (MELD) score (20.4 [6-73] vs. 18.3 [6-70], p < 0.01), but had the lowest one- and five-yr graft survival (p < 0.01). Of 30 474 livers, 5056 were not transplanted, of which 3690 were procured outside Region 9 but met Region 9 use criteria. Of these, 1488 and 1807 livers had donor risk indices < 2, for hypothetical 12 and 8 h cold ischemia time (CIT), respectively. Regional differences in liver utilization are profound. Region 9 is significantly more aggressive. At the most, 297-361 organs per year may have been used under Region 9's use criteria but overall graft survival may have declined.
Details
- Title: Subtitle
- Regional differences in deceased donor liver transplantation and their implications for organ utilization and allocation
- Creators
- Paul H. Hayashi - University of North Carolina at Chapel HillDavid A. Axelrod - Dartmouth–Hitchcock Medical CenterJoseph Galanko - University of North Carolina at Chapel HillPaolo R. Salvalaggio - University of WashingtonMark Schnitzler - Saint Louis University
- Resource Type
- Journal article
- Publication Details
- Clinical transplantation, Vol.25(1), pp.156-163
- Publisher
- Wiley
- DOI
- 10.1111/j.1399-0012.2010.01214.x
- PMID
- 20156220
- ISSN
- 0902-0063
- eISSN
- 1399-0012
- Number of pages
- 8
- Language
- English
- Date published
- 01/01/2011
- Academic Unit
- Surgery
- Record Identifier
- 9984322957202771
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