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Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective

Background: The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors...

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Autores principales: Lin, Hui-Ying, Ho, Cheng-Maw, Hsieh, Pei-Yin, Lin, Min-Heuy, Wu, Yao-Ming, Ho, Ming-Chih, Lee, Po-Huang, Hu, Rey-Heng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625845/
https://www.ncbi.nlm.nih.gov/pubmed/34834525
http://dx.doi.org/10.3390/jpm11111173
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author Lin, Hui-Ying
Ho, Cheng-Maw
Hsieh, Pei-Yin
Lin, Min-Heuy
Wu, Yao-Ming
Ho, Ming-Chih
Lee, Po-Huang
Hu, Rey-Heng
author_facet Lin, Hui-Ying
Ho, Cheng-Maw
Hsieh, Pei-Yin
Lin, Min-Heuy
Wu, Yao-Ming
Ho, Ming-Chih
Lee, Po-Huang
Hu, Rey-Heng
author_sort Lin, Hui-Ying
collection PubMed
description Background: The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. Methods: In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. Results: From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0–58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0–188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient’s critical illness, donor’s physical conditions, motivation for live donation, and stable condition while on the waiting list. Conclusions: Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process.
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spelling pubmed-86258452021-11-27 Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective Lin, Hui-Ying Ho, Cheng-Maw Hsieh, Pei-Yin Lin, Min-Heuy Wu, Yao-Ming Ho, Ming-Chih Lee, Po-Huang Hu, Rey-Heng J Pers Med Article Background: The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. Methods: In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. Results: From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0–58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0–188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient’s critical illness, donor’s physical conditions, motivation for live donation, and stable condition while on the waiting list. Conclusions: Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process. MDPI 2021-11-10 /pmc/articles/PMC8625845/ /pubmed/34834525 http://dx.doi.org/10.3390/jpm11111173 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lin, Hui-Ying
Ho, Cheng-Maw
Hsieh, Pei-Yin
Lin, Min-Heuy
Wu, Yao-Ming
Ho, Ming-Chih
Lee, Po-Huang
Hu, Rey-Heng
Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_full Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_fullStr Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_full_unstemmed Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_short Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_sort circuitous path to live donor liver transplantation from the coordinator’s perspective
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625845/
https://www.ncbi.nlm.nih.gov/pubmed/34834525
http://dx.doi.org/10.3390/jpm11111173
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