Estimating the effect of increasing utilization of living donor liver transplantation using observational data
| العنوان: | Estimating the effect of increasing utilization of living donor liver transplantation using observational data |
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| المؤلفون: | Aaron L. Sarvet, Roberto Hernandez-Alejandro, Koji Tomiyama, Bandar Al-Judaibi, Kerollos Nashat Wanis, Luis I. Ruffolo, Mats Julius Stensrud, Mark Levstik |
| المصدر: | Transplant International. 34 |
| بيانات النشر: | Frontiers Media SA, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Pediatrics, medicine.medical_specialty, Waiting Lists, 030230 surgery, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, Living Donors, Risk of mortality, Humans, Medicine, Cumulative incidence, Retrospective Studies, Transplantation, business.industry, Incidence, Inverse probability weighting, Transplant Waiting List, United States, Liver Transplantation, Treatment Outcome, Cohort, 030211 gastroenterology & hepatology, Observational study, business |
| الوصف: | BACKGROUND: There has been a recent increase in enthusiasm for expansion of living donor liver transplantation (LDLT) programs. METHODS: Using all adults initially placed on the waiting list in the US, we estimated the risk of overall mortality under national strategies which differed in their utilization of LDLT. We used a generalization of inverse probability weighting which can estimate the effect of interventions in the setting of finite resources. RESULTS: From 2005 to 2015, 93,812 eligible individuals were added to the waitlist - 51,322 received deceased donor grafts while 1,970 underwent LDLT. Individuals who underwent LDLT had more favourable prognostic factors, including lower mean MELD score at transplant (14.6 vs 20.5). The 1-year, 5-year, and 10-year cumulative incidence of death under the current level of LDLT utilization were 18.0% (95% CI: 17.8, 18.3%), 41.2% (95% CI: 40.8, 41.5%), and 57.4% (95% CI: 56.9, 57.9%) compared to 17.9% (95% CI: 17.7, 18.2%), 40.6% (95% CI: 40.2, 40.9%), and 56.4% (95% CI: 55.8, 56.9%) under a strategy which doubles LDLT utilization. CONCLUSION: Expansion of LDLT utilization would have a measurable, modest effect on the risk of mortality for the entire cohort of individuals who begin on the transplant waiting list. |
| اللغة: | English |
| تدمد: | 0934-0874 1432-2277 |
| DOI: | 10.1111/tri.13835 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::86d8d6321d4aa9bd6b3769b29713e6e4Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....86d8d6321d4aa9bd6b3769b29713e6e4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 09340874 14322277 |
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| DOI: | 10.1111/tri.13835 |