Gender Differences in Liver Transplantation Outcomes in Polycystic Liver Disease

Chauhan, Mahak; Zhang, Talan; Thuluvath, Paul J.

doi:10.1007/s10620-021-07125-9

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…In a recent study of adults transplanted for PCLD over a 20-year period, post-transplant mortality was 46% lower in women than men. 143 …”

Section: Fibrotic Diseasesmentioning

confidence: 99%

Sex differences in chronic liver disease and benign liver lesions

Cooper,

Delk,

Devuni

et al. 2023

JHEP Reports

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“…In a recent study of adults transplanted for PCLD over a 20-year period, post-transplant mortality was 46% lower in women than men. 143 …”

Section: Fibrotic Diseasesmentioning

confidence: 99%

Sex differences in chronic liver disease and benign liver lesions

Cooper,

Delk,

Devuni

et al. 2023

JHEP Reports

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“…Female liver transplant recipients demonstrate comparable, if not better, outcomes than males across a number of etiologies; however, as their access to liver transplant is limited, female patients are getting progressively sicker while waiting and risk being removed from the transplant list while their male counterparts undergo successful transplant[ 14 - 18 ]. It is clear that more research into sex-related differences in transplant patients is needed to identify areas for improvement.…”

Section: Introductionmentioning

confidence: 99%

Impact of sex on the outcomes of deceased donor liver transplantation

Andacoglu,

Dennahy,

Mountz

et al. 2024

World J Transplant

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BACKGROUND Data examining the impact of sex on liver transplant (LT) outcomes are limited. It is clear that further research into sex-related differences in transplant patients is necessary to identify areas for improvement. Elucidation of these differences may help to identify specific areas of focus to improve on the organ matching process, as well as the peri- and post-operative care of these patients. AIM To utilize data from a high-volume Eurotransplant center to compare characteristics of male and female patients undergoing liver transplant and assess association between sex-specific variables with short- and long-term post-transplant outcomes. METHODS A retrospective review of the University of Essen’s transplant database was performed with collection of baseline patient characteristics, transplant-related data, and short-term outcomes. Comparisons of these data were made with Shapiro-Wilk, Mann-Whitney U , χ 2 and Bonferroni tests applied where appropriate. A P value of < 0.05 was accepted as statistically significant. RESULTS Of the total 779 LT recipients, 261 (33.5%) were female. Female patients suffered higher incidences of acute liver failure and lower incidences of alcohol-related or viremic liver disease (P = 0.001). Female patients were more likely to have received an organ from a female donor with a higher donor risk index score, and as a high urgency offer (all P < 0.05). Baseline characteristics of male and female recipients were also significantly different. In multivariate hazard regression analysis, recipient lab-Model for End-Stage Liver Disease score and donor cause of death were associated with long-term outcomes in females. Pre-operative diagnosis of hepatocellular carcinoma, age at time of listing, duration of surgery, and units transfused during surgery, were associated with long-term outcomes in males. Severity of complications was associated with long-term outcomes in both groups. Overall survival was similar in both males and females; however, when stratified by age, females < 50 years of age had the best survival. CONCLUSION Female and male LT recipients have different baseline and transplant-related characteristics, with sex-specific variables which are associated with long-term outcomes. Female recipients < 50 years of age demonstrated the best long-term outcomes. Pre- and post-transplant practices should be individualized based on sex-specific variables to optimize long-term outcomes.

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“…5 The MELD exception policy for patients with PLKD was implemented in 2002. It was reported that the percentage of patients with PLKD who underwent SLKT with exception points has increased from 30% 6 to 50% 7 lately, whereas SLKT waitlist outcomes according to the exception policy change were not well studied.…”

Section: Introductionmentioning

confidence: 99%

Exception Policy Change Increased the Simultaneous Kidney-liver Transplant Probability of Polycystic Disease in the Centers With High Median MELD at Transplantation

Miyake,

Kim,

Chau

et al. 2024

Transplantation

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Background. In 2019, Organ Procurement and Transplantation Network/United Network for Organ Sharing changed the exception policy for liver allocation to the median model for end-stage liver disease at transplantation (MMaT). This study evaluated the effects of this change on-waitlist outcomes of simultaneous liver-kidney transplantation (SLKT) for patients with polycystic liver-kidney disease (PLKD). Methods. Using the Organ Procurement and Transplantation Network/United Network for Organ Sharing registry, 317 patients with PLKD listed for SLKT between January 2016 and December 2021 were evaluated. Waitlist outcomes were compared between prepolicy (Era 1) and postpolicy (Era 2) eras. Results. One-year transplant probability was significantly higher in Era 2 than in Era 1 (55.7% versus 37.9%; P = 0.001), and the positive effect on transplant probability of Era 2 was significant after risk adjustment (adjusted hazard ratio, 1.76; 95% confidence interval, 1.22-2.54; P = 0.002 [ref. Era 1]), whereas waitlist mortality was comparable. Transplant centers were separated into the high and low MMaT groups with a score of 29 (median MMaT) and transplant probability in each group between eras was compared. In the high MMaT transplant centers, the 1-y transplant probability was significantly higher in Era 2 (27.5% versus 52.4%; P = 0.003). The positive effect remained significant in the high MMaT center group (adjusted hazard ratio, 2.79; 95% confidence interval, 1.43-5.46; P = 0.003 [ref. Era 1]) but not in the low MMaT center group. Although there was a difference between center groups in Era 1 (P = 0.006), it became comparable in Era 2 (P = 0.54). Conclusions. The new policy increased 1-y SLKT probability in patients with PKLD and successfully reduced the disparities based on center location.

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Gender Differences in Liver Transplantation Outcomes in Polycystic Liver Disease

Cited by 4 publications

References 24 publications

Sex differences in chronic liver disease and benign liver lesions

Sex differences in chronic liver disease and benign liver lesions

Impact of sex on the outcomes of deceased donor liver transplantation

Exception Policy Change Increased the Simultaneous Kidney-liver Transplant Probability of Polycystic Disease in the Centers With High Median MELD at Transplantation

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