| dc.contributor |
Scientific Registry of Transplant Recipients, Department of Surgery, University of Michigan, Ann Arbor, MI |
|
| dc.contributor |
Department of Pediatrics and Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA ; Telephone: 310-206-6136; FAX: 310-206-0203 ; UCLA Medical Center, Room 12-383 MDCC, 10833 Le Conte Avenue, Los Angeles, CA 90095 |
|
| dc.contributor |
Analytic Support, Scientific Registry of Transplant Recipients, Arbor Research Collaborative for Health, Ann Arbor, MI |
|
| dc.contributor |
Research Department, United Network for Organ Sharing, Richmond, VA |
|
| dc.creator |
McDiarmid, Suzanne V. |
|
| dc.creator |
Goodrich, Nathan P. |
|
| dc.creator |
Harper, Ann M. |
|
| dc.creator |
Merion, Robert M. |
|
| dc.date |
2007-09-20T18:34:07Z |
|
| dc.date |
2008-09-08T14:25:14Z |
|
| dc.date |
2007-05 |
|
| dc.date.accessioned |
2022-05-19T13:29:55Z |
|
| dc.date.available |
2022-05-19T13:29:55Z |
|
| dc.identifier |
McDiarmid, Sue V.; Goodrich, Nathan P.; Harper, Ann M.; Merion, Robert M. (2007)."Liver transplantation for status 1: The consequences of good intentions The views expressed herein are those of the authors and not necessarily those of the U.S. government. This study was approved by the U.S. Health Resources and Services Administration (HRSA) Scientific Registry of Transplant Recipients project officer. HRSA has determined that this study satisfies the criteria for the IRB exemption described in the “Public Benefit and Service Program” provisions of 45 CFR 46.101(b) (5) and HRSA Circular 03. ." Liver Transplantation 13(5): 699-707. <http://hdl.handle.net/2027.42/56028> |
|
| dc.identifier |
1527-6465 |
|
| dc.identifier |
1527-6473 |
|
| dc.identifier |
http://hdl.handle.net/2027.42/56028 |
|
| dc.identifier |
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=17457930&dopt=citation |
|
| dc.identifier |
17457930 |
|
| dc.identifier |
http://dx.doi.org/10.1002/lt.21125 |
|
| dc.identifier |
Liver Transplantation |
|
| dc.identifier.uri |
http://localhost:8080/xmlui/handle/CUHPOERS/117304 |
|
| dc.description |
Status 1 is the listing category reserved for patients awaiting liver transplantation who are at risk of imminent death. This high allocation priority was intended to benefit patients with acute liver failure and children with severe chronic liver failure. However, the status 1 criteria were not well defined. The aims of this study, which used the Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients database for patients wait-listed between February 27, 2002, and September 30, 2003, were to determine the indication and numbers of children and adults at status 1 (including regional variations); examine death rates on the waiting list for children at vs. not at status 1; and examine time to death, transplant, or removal from the waiting list for both pediatric and adult status 1 candidates. During the study period, 40.3% of children and 6.1% of adults were transplanted at status 1. The indication was acute liver failure in 52.1% of adults and 31% of children. Among status 1 transplants, Regional Review Board exceptions were granted for 16.7% of children and 10.1% of adults. Death rates for children listed at status 1 by exception per patient-year at risk were substantially lower (0.51) than those of children with acute liver failure (4.06) or with chronic liver disease and Pediatric End-Stage Liver Disease score ≥25 (4.63). The percentage of adults who died while on the waiting list within 90 days of listing was more than twice that of children, whereas the percentages transplanted were similar. Patients listed and transplanted at status 1 were a heterogeneous population with an overrepresentation of children with varying degrees of chronic liver disease and other exceptions, and an associated wide variation in waiting list mortality. Recent changes in status 1 criteria provide stricter definitions, particularly for children, including the removal of the “by exception” category, with the intent that all candidates listed at status 1 share a similar mortality risk. Liver Transpl 13:699–707, 2007. © 2007 AASLD. |
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| dc.description |
Peer Reviewed |
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| dc.description |
http://deepblue.lib.umich.edu/bitstream/2027.42/56028/1/21125_ftp.pdf |
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| dc.format |
137044 bytes |
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| dc.format |
3118 bytes |
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| dc.format |
application/pdf |
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| dc.format |
text/plain |
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| dc.format |
application/pdf |
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| dc.publisher |
Wiley Subscription Services, Inc., A Wiley Company |
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| dc.rights |
IndexNoFollow |
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| dc.subject |
Life and Medical Sciences |
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| dc.subject |
Surgery |
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| dc.subject |
Health Sciences |
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| dc.title |
Liver transplantation for status 1: The consequences of good intentions |
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| dc.type |
Article |
|