Current policy for allocation of donor livers in the Netherlands advantages primary sclerosing cholangitis patients on the liver transplantation waiting list-a retrospective study

Studies from the USA and Nordic countries indicate primary sclerosing cholangitis (PSC) patients have low mortality on the liver transplantation (LTx) waiting list. However, this may vary among geographical areas. Therefore, we compared waiting list mortality and post-transplant survival between laboratory model for end-stage liver disease (LM) and MELD exception (ME)-prioritized PSC and non-PSC candidates in a nationwide study in the Netherlands. A retrospective analysis of patients waitlisted from 2006 to 2013 was conducted. A total of 852 candidates (146 PSC) were waitlisted of whom 609 (71... Mehr ...

Verfasser: Goet, Jorn C
Hansen, Bettina E
Tieleman, Madelon
van Hoek, Bart
van den Berg, Aad P
Polak, Wojciech G
Dubbeld, Jeroen
Porte, Robert J
Konijn-Janssen, Cynthia
de Man, Robert A
Metselaar, Herold J
de Vries, Annemarie C
Dokumenttyp: Artikel
Erscheinungsdatum: 2018
Reihe/Periodikum: Goet , J C , Hansen , B E , Tieleman , M , van Hoek , B , van den Berg , A P , Polak , W G , Dubbeld , J , Porte , R J , Konijn-Janssen , C , de Man , R A , Metselaar , H J & de Vries , A C 2018 , ' Current policy for allocation of donor livers in the Netherlands advantages primary sclerosing cholangitis patients on the liver transplantation waiting list-a retrospective study ' , Transplant International , vol. 31 , no. 6 , pp. 590-599 . https://doi.org/10.1111/tri.13097
Schlagwörter: Primary sclerosing cholangitis / exception points / liver transplantation / waiting list mortality / COMPETING RISKS / SURVIVAL / DISEASE / RECURRENCE / MODEL / MALIGNANCIES / OUTCOMES / DEATHS / CANCER / MELD
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29191374
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/6fc351fb-add2-454b-b27f-1c644ef35674

Studies from the USA and Nordic countries indicate primary sclerosing cholangitis (PSC) patients have low mortality on the liver transplantation (LTx) waiting list. However, this may vary among geographical areas. Therefore, we compared waiting list mortality and post-transplant survival between laboratory model for end-stage liver disease (LM) and MELD exception (ME)-prioritized PSC and non-PSC candidates in a nationwide study in the Netherlands. A retrospective analysis of patients waitlisted from 2006 to 2013 was conducted. A total of 852 candidates (146 PSC) were waitlisted of whom 609 (71.5%) underwent LTx and 159 (18.7%) died before transplantation. None of the ME PSC patients died, and they had a higher probability of LTx than LM PSC [HR obtained by considering ME as a time-dependent covariate (HRME 9.86; 95% CI 6.14-15.85)] and ME non-PSC patients (HRME 4.60; 95% CI 3.78-5.61). After liver transplantation, PSC patients alive at 3 years of follow-uyp had a higher probability of relisting than non-PSC patients (HR 7.94; 95% CI 1.98-31.85) but a significantly lower mortality (HR 0.51; 95% CI 0.27-0.95). In conclusion, current LTx prioritization advantages PSC patients on the LTx waiting list. Receiving ME points is strongly associated with timel LTx.