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Liver.

W R Kim1,2, J R Lake2,3, J M Smith2,4

  • 1Division of Gastroenterology and Hepatology, Stanford Univerity, Palo Alto, CA.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|January 13, 2016
PubMed
Summary
This summary is machine-generated.

The Share 35 policy significantly reduced liver transplant wait times and mortality for patients with high MELD scores. Pediatric liver transplant numbers also saw changes, with improved graft survival.

Keywords:
Liver transplantmodel for end-stage liver diseasewaiting list

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Area of Science:

  • Hepatology and Transplant Surgery
  • Public Health Policy and Outcomes Research

Background:

  • Liver transplantation is a critical treatment for end-stage liver disease.
  • Organ allocation policies significantly impact patient access and outcomes.
  • The Share 35 policy aimed to improve equity and efficiency in liver allocation.

Purpose of the Study:

  • To evaluate the impact of the Share 35 policy on liver transplant waiting times and mortality.
  • To analyze trends in the pediatric liver transplant waiting list and transplant volume.
  • To assess graft survival rates in pediatric liver transplant recipients.

Main Methods:

  • Analysis of national liver transplant waiting list data before and after the Share 35 policy implementation.
  • Comparison of median waiting times and mortality rates for patients with MELD ≥ 35.
  • Examination of pediatric candidate demographics, transplant numbers (deceased and living donor), and graft survival.

Main Results:

  • Median waiting time for MELD ≥ 35 patients decreased from 18 to 9 days post-Share 35.
  • Mortality for MELD ≥ 35 candidates decreased from 366 to 315 per 100 waitlist years.
  • Pediatric liver transplants showed improved graft survival for both deceased and living donor recipients.

Conclusions:

  • The Share 35 policy effectively reduced waiting times and mortality for critically ill liver transplant candidates.
  • Trends in pediatric liver transplantation indicate a declining waiting list and stable transplant volume.
  • Continuous improvement in graft survival highlights advancements in pediatric liver transplant care.