Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2006-2-7
pubmed:abstractText
Living donors represent a recognized alternative for facilitating the access to transplantation in a period of organ shortage. However, which candidates should be preferentially considered for living-donor liver transplantation (LDLT) is debated. The aim of this study was to create statistical models to determine which strategies of selection for LDLT provide the most efficient contribution. The study included 331 patients listed for deceased-donor transplantation (DDLT) and 128 transplanted with living donors. Statistical models predicting the events following listing were created and combined in a multistate model allowing the testing of different strategies of selection for LDLT and to compare their results. Taking 3-yr survival after listing as the principal end-point, selecting the 20% patients at highest risk of death on the waiting list gave better results than selecting the 20% patients at lowest risk of death after LDLT (70% vs. 64%, respectively). These strategies resulted in waiting list mortality rates of 17% and 8%, respectively. One-year survival after LDLT was lower in high-risk patients (85%) than in low-risk patients (91%). However, the 1-yr survival benefit derived from LDLT was 75% in high-risk patients while it was nil in low-risk patients. In conclusion, LDLT is more effective for overcoming the consequences of organ shortage when performed in patients at high risk of death on the waiting list. On an individual basis, the sickest patients are those who derive the most important benefit from LDLT. This study provides incentives for considering LDLT in high-risk patients.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
1527-6465
pubmed:author
pubmed:copyrightInfo
Copyright 2006 AASLD
pubmed:issnType
Print
pubmed:volume
12
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
231-9
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:16447208-Adolescent, pubmed-meshheading:16447208-Adult, pubmed-meshheading:16447208-Age Factors, pubmed-meshheading:16447208-Cause of Death, pubmed-meshheading:16447208-Cohort Studies, pubmed-meshheading:16447208-Female, pubmed-meshheading:16447208-Follow-Up Studies, pubmed-meshheading:16447208-Graft Rejection, pubmed-meshheading:16447208-Graft Survival, pubmed-meshheading:16447208-Humans, pubmed-meshheading:16447208-Liver Failure, pubmed-meshheading:16447208-Liver Transplantation, pubmed-meshheading:16447208-Living Donors, pubmed-meshheading:16447208-Male, pubmed-meshheading:16447208-Middle Aged, pubmed-meshheading:16447208-Models, Statistical, pubmed-meshheading:16447208-Patient Selection, pubmed-meshheading:16447208-Predictive Value of Tests, pubmed-meshheading:16447208-Retrospective Studies, pubmed-meshheading:16447208-Risk Assessment, pubmed-meshheading:16447208-Sex Factors, pubmed-meshheading:16447208-Survival Analysis, pubmed-meshheading:16447208-Tissue and Organ Procurement, pubmed-meshheading:16447208-Waiting Lists
pubmed:year
2006
pubmed:articleTitle
Living donor liver transplantation in high-risk vs. low-risk patients: optimization using statistical models.
pubmed:affiliation
Hepatology-INSERM U481, Hospital Beaujon, Clichy, France. francois.durand@bjn.ap-hop-paris.fr
pubmed:publicationType
Journal Article, Comparative Study, Research Support, Non-U.S. Gov't