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CHICAGO — Extended criteria for liver donor allografts, including the use of living donors, increase access to liver transplantation and significantly reduce wait-list mortality while providing satisfactory outcomes, according to researchers at New York-Presbyterian Hospital.
Allografts that do not meet traditional donor criteria can offer immediate expansion of the donor pool in regions of donor scarcity, said Cindy Kin, a medical student at the hospital and lead author of the study, at the annual Digestive Disease Week. As of August, approximately 2,200 people were waiting for a liver in New York, which is second only to California for the nation's longest wait list, according to the United Network for Organ Sharing (UNOS).
In a study conducted between April 2001 and April 2004, Ms. Kin and her coauthors compared patient access to and outcomes of liver transplantation between two groups: 128 recipients of primarily traditional donor criteria allografts and 99 recipients of extended donor criteria (EDC) allografts. The latter group included allografts from cadaver donors who were older than 65 years of age at time of death; had cardiac death or a history of cancer; were positive for hepatitis C, hepatitis B core antibody, or human T-lymphotropic virus; had macrovesicular steatosis above 40% or a serum sodium level exceeding 155 mEq/dL; or engaged in high-risk behaviors. Allografts from living donors also were included in the EDC group, as were split-liver cadaver allografts.
Data collected during the 3-year study period revealed that systematic use of EDC in select recipients increased patient access to liver transplantation by 77% and reduced mortality before transplantation by more than 50%, compared with use of primarily traditional donor allografts, Ms. Kin reported.
The allocation of EDC livers involved careful selection of patients suited to allograft and advance planning to prepare patients who face potentially long wait times for the use of EDC, Ms. Kin said in an interview.
Biliary complications were more common in living donor transplant recipients, but vascular and wound complications did not vary between groups, she said.
CHICAGO — Extended criteria for liver donor allografts, including the use of living donors, increase access to liver transplantation and significantly reduce wait-list mortality while providing satisfactory outcomes, according to researchers at New York-Presbyterian Hospital.
Allografts that do not meet traditional donor criteria can offer immediate expansion of the donor pool in regions of donor scarcity, said Cindy Kin, a medical student at the hospital and lead author of the study, at the annual Digestive Disease Week. As of August, approximately 2,200 people were waiting for a liver in New York, which is second only to California for the nation's longest wait list, according to the United Network for Organ Sharing (UNOS).
In a study conducted between April 2001 and April 2004, Ms. Kin and her coauthors compared patient access to and outcomes of liver transplantation between two groups: 128 recipients of primarily traditional donor criteria allografts and 99 recipients of extended donor criteria (EDC) allografts. The latter group included allografts from cadaver donors who were older than 65 years of age at time of death; had cardiac death or a history of cancer; were positive for hepatitis C, hepatitis B core antibody, or human T-lymphotropic virus; had macrovesicular steatosis above 40% or a serum sodium level exceeding 155 mEq/dL; or engaged in high-risk behaviors. Allografts from living donors also were included in the EDC group, as were split-liver cadaver allografts.
Data collected during the 3-year study period revealed that systematic use of EDC in select recipients increased patient access to liver transplantation by 77% and reduced mortality before transplantation by more than 50%, compared with use of primarily traditional donor allografts, Ms. Kin reported.
The allocation of EDC livers involved careful selection of patients suited to allograft and advance planning to prepare patients who face potentially long wait times for the use of EDC, Ms. Kin said in an interview.
Biliary complications were more common in living donor transplant recipients, but vascular and wound complications did not vary between groups, she said.
CHICAGO — Extended criteria for liver donor allografts, including the use of living donors, increase access to liver transplantation and significantly reduce wait-list mortality while providing satisfactory outcomes, according to researchers at New York-Presbyterian Hospital.
Allografts that do not meet traditional donor criteria can offer immediate expansion of the donor pool in regions of donor scarcity, said Cindy Kin, a medical student at the hospital and lead author of the study, at the annual Digestive Disease Week. As of August, approximately 2,200 people were waiting for a liver in New York, which is second only to California for the nation's longest wait list, according to the United Network for Organ Sharing (UNOS).
In a study conducted between April 2001 and April 2004, Ms. Kin and her coauthors compared patient access to and outcomes of liver transplantation between two groups: 128 recipients of primarily traditional donor criteria allografts and 99 recipients of extended donor criteria (EDC) allografts. The latter group included allografts from cadaver donors who were older than 65 years of age at time of death; had cardiac death or a history of cancer; were positive for hepatitis C, hepatitis B core antibody, or human T-lymphotropic virus; had macrovesicular steatosis above 40% or a serum sodium level exceeding 155 mEq/dL; or engaged in high-risk behaviors. Allografts from living donors also were included in the EDC group, as were split-liver cadaver allografts.
Data collected during the 3-year study period revealed that systematic use of EDC in select recipients increased patient access to liver transplantation by 77% and reduced mortality before transplantation by more than 50%, compared with use of primarily traditional donor allografts, Ms. Kin reported.
The allocation of EDC livers involved careful selection of patients suited to allograft and advance planning to prepare patients who face potentially long wait times for the use of EDC, Ms. Kin said in an interview.
Biliary complications were more common in living donor transplant recipients, but vascular and wound complications did not vary between groups, she said.