Tags

Type your tag names separated by a space and hit enter

Mortality in candidates waiting for combined liver-intestine transplants exceeds that for other candidates waiting for liver transplants.
Liver Transpl. 2003 Jul; 9(7):748-53.LT

Abstract

The United Network for Organ Sharing (UNOS) reports indicate that mortality on the intestine transplant waiting list is higher than on other transplant waiting lists. The goals of this study were (1) to determine whether most of the intestinal transplant candidate deaths have occurred in those who also need liver transplants, and (2) to compare the waiting list mortality in the liver-intestine candidate subset with the overall liver transplant candidate population. We found that 90% of intestine transplant waiting list deaths have occurred in candidates who also needed liver transplants. Since 1994, annual mortality has been higher in liver-intestine transplant candidates than in the overall liver transplant candidate population, and these differences have been statistically significant since 1996. These mortality differences applied to all age groups. Also, status 2B, 3, and 7 candidate mortality was significantly higher in liver-intestine candidates than in the overall liver transplant candidate population. Because there were so few liver-intestine transplant candidates listed as status 1 or 2A, a meaningful comparison was not possible in these statuses. These data indicate that liver-intestine transplant candidates are a unique subset of liver transplant candidates with a significantly higher risk of dying on the waiting list. Recent changes in UNOS liver allocation policy that gives higher priority to liver-intestine candidates may help to reduce this discrepancy. However, further research into the etiology of liver disease in patients on long-term parenteral nutrition and earlier referral of high-risk short bowel syndrome patients to centers with special expertise in their management are needed for an ultimate solution to this problem.

Authors+Show Affiliations

Department of Surgery, Northwestern University Medical School, Chicago, IL 60611, USA. jfryer@nmh.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12827564

Citation

Fryer, Jonathan, et al. "Mortality in Candidates Waiting for Combined Liver-intestine Transplants Exceeds That for Other Candidates Waiting for Liver Transplants." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 9, no. 7, 2003, pp. 748-53.
Fryer J, Pellar S, Ormond D, et al. Mortality in candidates waiting for combined liver-intestine transplants exceeds that for other candidates waiting for liver transplants. Liver Transpl. 2003;9(7):748-53.
Fryer, J., Pellar, S., Ormond, D., Koffron, A., & Abecassis, M. (2003). Mortality in candidates waiting for combined liver-intestine transplants exceeds that for other candidates waiting for liver transplants. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 9(7), 748-53.
Fryer J, et al. Mortality in Candidates Waiting for Combined Liver-intestine Transplants Exceeds That for Other Candidates Waiting for Liver Transplants. Liver Transpl. 2003;9(7):748-53. PubMed PMID: 12827564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality in candidates waiting for combined liver-intestine transplants exceeds that for other candidates waiting for liver transplants. AU - Fryer,Jonathan, AU - Pellar,Suzanne, AU - Ormond,Debra, AU - Koffron,Allan, AU - Abecassis,Michael, PY - 2003/6/27/pubmed PY - 2003/9/17/medline PY - 2003/6/27/entrez SP - 748 EP - 53 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl. VL - 9 IS - 7 N2 - The United Network for Organ Sharing (UNOS) reports indicate that mortality on the intestine transplant waiting list is higher than on other transplant waiting lists. The goals of this study were (1) to determine whether most of the intestinal transplant candidate deaths have occurred in those who also need liver transplants, and (2) to compare the waiting list mortality in the liver-intestine candidate subset with the overall liver transplant candidate population. We found that 90% of intestine transplant waiting list deaths have occurred in candidates who also needed liver transplants. Since 1994, annual mortality has been higher in liver-intestine transplant candidates than in the overall liver transplant candidate population, and these differences have been statistically significant since 1996. These mortality differences applied to all age groups. Also, status 2B, 3, and 7 candidate mortality was significantly higher in liver-intestine candidates than in the overall liver transplant candidate population. Because there were so few liver-intestine transplant candidates listed as status 1 or 2A, a meaningful comparison was not possible in these statuses. These data indicate that liver-intestine transplant candidates are a unique subset of liver transplant candidates with a significantly higher risk of dying on the waiting list. Recent changes in UNOS liver allocation policy that gives higher priority to liver-intestine candidates may help to reduce this discrepancy. However, further research into the etiology of liver disease in patients on long-term parenteral nutrition and earlier referral of high-risk short bowel syndrome patients to centers with special expertise in their management are needed for an ultimate solution to this problem. SN - 1527-6465 UR - https://www.unboundmedicine.com/medline/citation/12827564/Mortality_in_candidates_waiting_for_combined_liver_intestine_transplants_exceeds_that_for_other_candidates_waiting_for_liver_transplants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1527646503003150 DB - PRIME DP - Unbound Medicine ER -