Liver Graft Allocation by Means of a New, Regionally Shared “Mixed” Model: The Experience in Lazio

Zaccaria, R.; Teti, G.; Meçule, A.; Torlone, N.; Valeri, M; Adorno, D.

doi:10.1016/j.transproceed.2014.11.075

Cited by 2 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Standard criterion donors (<65 years old) are offered to the highest‐ranking patient by MELD in the region, whereas extended criteria donors are used locally. Following introduction of regional sharing between the four centers in the Lazio region, there was a reduction in waiting list mortality from 22% to 14%, although the largest reduction was in patients with hepatocellular carcinoma 17 …”

Section: Discussionmentioning

confidence: 99%

Impact of Share 35 liver transplantation allocation in Australia and New Zealand

Fink,

Gow,

McCaughan

et al. 2023

Clinical Transplantation

View full text Add to dashboard Cite

Patients with high model for end‐stage liver disease (MELD) scores waiting for liver transplantation in Australia and New Zealand (ANZ) have had limited access to deceased donor livers and therefore binational sharing of livers, for patients with a MELD score ≥35 was introduced in February 2016. Waiting list mortality, post‐transplant outcomes and intention‐to‐treat survival were compared between patients whose MELD score reached 35 on the waiting list between October 2013 and April 2015 (Pre‐Share 35 group, n = 23) and patients who were Share 35 listed between February 2016 and May 2022 (Share 35 group, n = 112). There was significantly reduced waiting list mortality in share 35 listed patients in comparison to the pre‐Share 35 group (11.7% vs. 52.2%, OR .120 95% CI .044–.328, P < .001). Post‐transplant patient and graft survival were not significantly different between the groups (5‐year patient survival 82% vs. 84%, P = .991, 5‐year graft survival 82% vs. 76%, P = .543). Intention‐to‐treat survival was superior in the Share 35 group (HR .302, 95% CI .149–.614, P < .001). Introduction of Share 35 in ANZ resulted in a 78% risk reduction in waiting list mortality, equivalent post‐transplant survival and an improvement in intention‐to‐treat survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Share 35 liver transplantation allocation in Australia and New Zealand

Fink,

Gow,

McCaughan

et al. 2023

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…With eRW-LT, but not with tRs, we found an inverse correlation between the waiting time from the referral date to the appointment date for the first visit and the MELD-R score, which is used to prioritize patients on the waiting list. 20 This is desirable because, even among patients who start transplant evaluation as an outpatient, some have such advanced disease that they are at risk of not reaching the transplant because of complications. These patients represent a fair number considering that the patients who started the transplant evaluation during a hospitalization during the study period, and who were not included in the study, were only 35% of the total patients considered for transplantation (data not shown).…”

Section: Discussionmentioning

confidence: 99%

“…The MELD-R score is used to prioritize patients who eventually enter the regional waiting list, also considering any additional points for MELD exceptions (Supplementary Methods). 20 Triage was not an option for patients referred with tRs. The site also provides links to the most up-to-date literature on LTs and the correct timing for referrals.…”

Section: Q15mentioning

confidence: 99%

“…The MELD-R score is used to prioritize patients who eventually enter the regional waiting list, also considering any additional points for MELD exceptions. 20 The MELD-R score corresponds to the MELDNa score or, for patients in whom the transplant indication is an exception to the MELD system, the MELD-R was defined by additional points fixed or granted by the Regional Board. 20 For example, for patients with HCC, if the laboratory MELDNa score was less than 18, the MELD-R at registration was 18, otherwise they were listed with a MELD-R corresponding to their MELDNa score.…”

Section: Electronic Referral Website For Liver Transplantationmentioning

confidence: 99%

“…20 The MELD-R score corresponds to the MELDNa score or, for patients in whom the transplant indication is an exception to the MELD system, the MELD-R was defined by additional points fixed or granted by the Regional Board. 20 For example, for patients with HCC, if the laboratory MELDNa score was less than 18, the MELD-R at registration was 18, otherwise they were listed with a MELD-R corresponding to their MELDNa score. Triage was not an option for visits of patients referred with tRs.…”

Section: Electronic Referral Website For Liver Transplantationmentioning

confidence: 99%

See 2 more Smart Citations

Electronic Outpatient Referral System for Liver Transplant Improves Appropriateness and Allows First Visit Triage

Ferri

Mihalj

Abbatecola

et al. 2022

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

BACKGROUND & AIMS: Q8Missed or inappropriate referrals of potential candidates for liver transplantation (LT) are common and traditional referral methods (tRs) do not allow for efficient triage. We investigated the effects of these issues on a website developed for electronic outpatient referral to LT (eRW-LT). METHODS:We prospectively collected data on all consecutive outpatient referrals to 2 Italian LT centers from January 2015 to December 2019. In the second half of the study, starting from July 2017, referring physicians had the option of using eRW-LT, quickly obtaining the judgment on the appropriateness and urgency of the visit from a transplant hepatologist. RESULTS:In the second half of the study, there were 99 eRW-LTs and 96 traditional referrals (new tRs), representing a 17.4% increase over the 161 traditional referrals (old tRs) of the first half. With eRW-LT, 11.1% of referrals were judged inappropriate online without booking a visit. Appropriateness, judged at the time of the first visit, was 59.6%, 56.2%, and 94.3% with old tRs, new tRs, and eRW-LT, respectively. Considering the appropriate visits, the median waiting time in days between referral date and first visit appointment was significantly shorter for urgent visits referred with eRW-LT (5.0; 95% CI, 4.8-9.3) compared with nonurgent visits sent with the same system (17.0; 95% CI, 11.5-25.0; P < .0001), those referred with old tRs (14.0; 95% CI, 8.0-23.0; P < .001) and with new tRs (16.0; 95% CI, 10.0-23.0; P < .001). CONCLUSIONS:eRW-LT allows an increase in the number of referrals for LT, ensuring effective triage and better appropriateness of visits.

show abstract

Liver Graft Allocation by Means of a New, Regionally Shared “Mixed” Model: The Experience in Lazio

Cited by 2 publications

References 5 publications

Impact of Share 35 liver transplantation allocation in Australia and New Zealand

Impact of Share 35 liver transplantation allocation in Australia and New Zealand

Electronic Outpatient Referral System for Liver Transplant Improves Appropriateness and Allows First Visit Triage

Contact Info

Product

Resources

About