Air transportation of patients with end-stage liver disease to distant liver transplantation centers

Shibolet, Oren; Safadi, Rifaat; Levy, Izhar; Zamir, Gideon; Eid, Ahmed; Donchin, Yoel; Ilan, Yaron

doi:10.1002/lt.20399

Cited by 5 publications

(5 citation statements)

References 25 publications

(49 reference statements)

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“…Nevertheless, it should be stressed that these results were based only on patients who return home excluding in hospital mortality and not of all the patients that went abroad. Shibolet and collegues reported that in spite of successful transportation overseas by precautious measures taken during long-distance transportation, a mortality rate of 30.2% occurred in patients while waiting for LT or following LT overseas (6). Therefore we cannot draw any conclusions on whether the overall patient and graft mortality of overseas OT was really 'comparable'.…”

Section: Discussionmentioning

confidence: 99%

Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

Kwon

Lee

2011

J Korean Med Sci

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The disparity between patients awaiting transplantation and available organs forced many patients to go overseas to receive a transplant. Few data concerning overseas transplantation in Korea are available and the Korea Society for Transplantation conducted a survey to evaluate the trend and outcome of overseas transplantation. The survey, conducted on June 2006, included 25 hospitals nationwide that followed up patients after receiving kidney transplant (KT) or liver transplant (LT) overseas. The number of KT increased from 6 in 2001 to 206 in 2005 and for LT from 1 to 261. The information about overseas transplant came mostly from other patients (57%). The mean cost for KT was $21,000 and for LT $47,000. Patients were admitted for 18.5 days for KT and 43.4 days for LT. Graft and patient survival was 96.8% and 96.5% for KT (median follow up 23.1 months). Complication occurred in 42.5% including surgical complication (5.3%), acute rejection (9.7%) and infection (21.5%). Patient survival for LT was 91.8% (median follow up 21.2 months). Complication occurred in 44.7% including 19.4% biliary complication. Overseas KT and LT increased rapidly from 2001 to 2005. Survival of patients and grafts was comparable to domestic organ transplantation, but had a high complication rate.

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Section: Discussionmentioning

confidence: 99%

Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

Kwon

Lee

2011

J Korean Med Sci

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“…The use of grafts from executed prisoners is arguable and has raised much concern from the rest of the world 21, 22. From the perspective of the patients' families, they have the right to look for all opportunities to save their beloved, especially in desperate situations 23. The transplant surgeon cannot prohibit them from going to regions where they may receive the grafts.…”

Section: Discussionmentioning

confidence: 99%

Follow-up of Chinese liver transplant recipients in Hong Kong

2009

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The outcome of liver transplantation in China remains speculative. From 1998 to 2007, 177 adult Hong Kong patients underwent liver transplantation in China and were subsequently followed up at Queen Mary Hospital, Hong Kong. One hundred six (59.9%) patients had hepatocellular carcinoma (HCC). The grafts were probably derived from uncontrolled non-heartbeating donors. The 1-month mortality rate was 4.0%. The 1-, 3-, and 5-year overall survival rates were 73.9%, 59.0%, and 53.9%, respectively. The 5-year overall survival rates for non-HCC, HCC, HCC (within the Milan criteria), and HCC (beyond the Milan criteria) patients were 66.3%, 44%, 58%, and 26.2%, respectively. The long-term survival was compromised by the high incidence of HCC recurrence and graft failure secondary to diffuse intrahepatic biliary strictures. The overall survival rate of the entire group was lower than that of the patients receiving deceased donor liver grafts at Queen Mary Hospital in the same period. For non-HCC patients, however, the 5-year survival rate of 66.3% was comparable to that of recent reports from the Western world. Liver Transpl 15: 544-550, 2009. © 2009 AASLD. Received October 8, 2008 accepted November 23, 2008. In Hong Kong, liver disease is common, yet the deceased organ donation rate is only 3 per million people per year. Although living donor liver transplantation (LDLT) is available locally, the operation is not always possible because hepatitis B is prevalent among family members and contraindicates living organ donation.

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“…21 Alternatively, recipients may be brought to the site of donation. In a study conducted by Shibolet et al, 22 43 Israeli liver transplant candidates were successfully transported internationally despite having high MELD scores. However, this entailed taking care of all logistical issues including arranging for visas, passports, health insurance coverage overseas, intensive care unit bed, ambulance, and availability of on call team comprising a hepatologist, anesthesia staff, and a nurse to assist with medical emergencies.…”

Section: Challenges Associated With Lpementioning

confidence: 99%

Liver Paired Exchange: Programmatic Hopes and Fears

et al. 2022

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The dearth of deceased liver donors has created a supply demand gap, necessitating creation of living donor liver transplantation. However, living donor liver transplantation has relied on directed donation, whereby many potential directed donors are rejected based on ABO blood group incompatibility, hepatic size incompatibility, or the need for biliary or arterial reconstruction during transplant surgery. Much like kidney paired exchange, liver paired exchange (LPE) circumvents these incompatibility issues by relying on anonymous, nondirected, or bridge donors that are better anatomical or histological matches for recipients. Although Asia has taken the lead in LPE, the process has only recently been adopted in North America, with the first successful surgery done in the United States in 2019. Our review article sheds light on the process of LPE and the success of LPE in the United States thus far and, additionally, highlights the several logistical and ethical challenges that must be considered as transplant centers adopt and scale up LPE across the United States to address the increased demand for liver allografts.

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Air transportation of patients with end-stage liver disease to distant liver transplantation centers

Abstract: The Israeli population does not meet its transplantation organ needs. Therefore, liver transplantation (LTX) candidates are sometimes transported to centers abroad. We aimed to assess the demographic and clinical issues concerning this policy. Records of all candidates transported

Cited by 5 publications

References 25 publications

Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

Follow-up of Chinese liver transplant recipients in Hong Kong

Liver Paired Exchange: Programmatic Hopes and Fears

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