共 31 条
Rising Trend in Waitlisting for Alcoholic Hepatitis With More Favorable Outcomes Than Other High Model for End-stage Liver Disease in the Current Era
被引:24
作者:

Bittermann, Therese
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机构:
Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA
Univ Penn, Perelman Sch Med, Dept Biostat Epidemiol & Informat, Philadelphia, PA USA Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA

Mahmud, Nadim
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h-index: 0
机构:
Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA
Univ Penn, Perelman Sch Med, Dept Biostat Epidemiol & Informat, Philadelphia, PA USA Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA

Weinberg, Ethan M.
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h-index: 0
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Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA

Reddy, K. Rajender
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h-index: 0
机构:
Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA
机构:
[1] Univ Penn, Perelman Sch Med, Div Gastroenterol & Hepatol, 3400 Spruce St, Philadelphia, PA 19104 USA
[2] Univ Penn, Perelman Sch Med, Dept Biostat Epidemiol & Informat, Philadelphia, PA USA
关键词:
TRANSPLANTATION;
SOCIETY;
D O I:
10.1097/TP.0000000000004049
中图分类号:
R392 [医学免疫学];
Q939.91 [免疫学];
学科分类号:
100102 ;
摘要:
Background. In the appropriate candidate, liver transplantation (LT) is a viable treatment for alcoholic hepatitis (AH). We compared the waitlisting trends and outcomes of AH patients in the context of others with high Model for End-stage Liver Disease (MELD) score. Methods. LT listings for AH between January 1, 2008, and June 12, 2020 were identified in the United Network for Organ Sharing database. Temporal trends in listings for AH were assessed. Covariate adjusted competing risks models evaluated waitlist mortality and LT rates between AH candidates and others with listing native MELD >= 30. Results. Between 2008 and 2019, waitlist additions for AH increased 6.5-fold. Waiting time for AH candidates was short (median 10 d). Delisting for clinical improvement was infrequent in AH, albeit higher than MELD >= 30 patients (3.3% versus 0.8%; P<0.001). Among 99 centers with >= 1 AH listing, AH patients accounted for 0.2%-18.2% of all alcohol-related listings and 0.6%-25.0% of those with native listing MELD >= 30. Overall listing volume was larger at these 99 centers than the 40 with no AH listings (P<0.001). AH candidates in 2014-2020 experienced improved waitlist survival (adjusted subhazard ratio, 0.67; 95% confidence interval, 0.52-0.86; P=0.002) and higher transplant rates (adjusted subhazard ratio, 1.14; 95% confidence interval, 1.04-1.25; P=0.006) versus other MELD >= 30 candidates. Conclusions. There has been a rising trend in waitlisting patients with AH and high MELD score. Liver disease causes influence waitlist outcomes and those of AH candidates are more favorable. Further research and allocation adjustments may be needed to ensure equitable organ allocation, based on liver disease cause, for those on the LT waitlist.
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页码:1401 / 1410
页数:10
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Michael E DeBakey VA Med Ctr, TX Ctr, Sect Gastroenterol, Houston, TX 77030 USA
Michael E DeBakey VA Med Ctr, Ctr Innovat Qual Effectiveness & Safety IQuESt, Houston, TX 77030 USA
Baylor Coll, Dept Med, Sect Gastroenterol & Hepatol, Houston, TX USA Michael E DeBakey VA Med Ctr, TX Ctr, Sect Gastroenterol, Houston, TX 77030 USA
[10]
Early Liver Transplantation for Severe Alcoholic Hepatitis in the United StatesA Single-Center Experience
[J].
Im, G. Y.
;
Kim-Schluger, L.
;
Shenoy, A.
;
Schubert, E.
;
Goel, A.
;
Friedman, S. L.
;
Florman, S.
;
Schiano, T. D.
.
AMERICAN JOURNAL OF TRANSPLANTATION,
2016, 16 (03)
:841-849

Im, G. Y.
论文数: 0 引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA

Kim-Schluger, L.
论文数: 0 引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA

Shenoy, A.
论文数: 0 引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA

Schubert, E.
论文数: 0 引用数: 0
h-index: 0
机构:
Mt Sinai Med Ctr, Social Work Serv, New York, NY 10029 USA Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA

Goel, A.
论文数: 0 引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Dept Med, Div Liver Dis, New York, NY 10029 USA Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA

Friedman, S. L.
论文数: 0 引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Dept Med, Div Liver Dis, New York, NY 10029 USA Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA

Florman, S.
论文数: 0 引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA

Schiano, T. D.
论文数: 0 引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, Dept Med, Div Liver Dis, New York, NY 10029 USA