Current policy for allocation of donor livers in the Netherlands advantages primary sclerosing cholangitis patients on the liver transplantation waiting list—a retrospective study
Summary Studies from the USA and Nordic countries indicate primary sclerosing cholangitis (PSC) patients have low mortality on the liver transplantation (LTx) waiting list. However, this may vary among geographical areas. Therefore, we compared waiting list mortality and post‐transplant survival bet...
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| Veröffentlicht in: | Transplant international 2018-06, Vol.31 (6), p.590-599 |
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| creator | Goet, Jorn C. Hansen, Bettina E. Tieleman, Madelon Hoek, Bart Berg, Aad P. Polak, Wojciech G. Dubbeld, Jeroen Porte, Robert J. Konijn‐Janssen, Cynthia Man, Robert A. Metselaar, Herold J. Vries, Annemarie C. |
| description | Summary
Studies from the USA and Nordic countries indicate primary sclerosing cholangitis (PSC) patients have low mortality on the liver transplantation (LTx) waiting list. However, this may vary among geographical areas. Therefore, we compared waiting list mortality and post‐transplant survival between laboratory model for end‐stage liver disease (LM) and MELD exception (ME)‐prioritized PSC and non‐PSC candidates in a nationwide study in the Netherlands. A retrospective analysis of patients waitlisted from 2006 to 2013 was conducted. A total of 852 candidates (146 PSC) were waitlisted of whom 609 (71.5%) underwent LTx and 159 (18.7%) died before transplantation. None of the ME PSC patients died, and they had a higher probability of LTx than LM PSC [HR obtained by considering ME as a time‐dependent covariate (HRME 9.86; 95% CI 6.14–15.85)] and ME non‐PSC patients (HRME 4.60; 95% CI 3.78–5.61). After liver transplantation, PSC patients alive at 3 years of follow‐up had a higher probability of relisting than non‐PSC patients (HR 7.94; 95% CI 1.98–31.85) but a significantly lower mortality (HR 0.51; 95% CI 0.27–0.95). In conclusion, current LTx prioritization advantages PSC patients on the LTx waiting list. Receiving ME points is strongly associated with timely LTx. |
| doi_str_mv | 10.1111/tri.13097 |
| format | Article |
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Studies from the USA and Nordic countries indicate primary sclerosing cholangitis (PSC) patients have low mortality on the liver transplantation (LTx) waiting list. However, this may vary among geographical areas. Therefore, we compared waiting list mortality and post‐transplant survival between laboratory model for end‐stage liver disease (LM) and MELD exception (ME)‐prioritized PSC and non‐PSC candidates in a nationwide study in the Netherlands. A retrospective analysis of patients waitlisted from 2006 to 2013 was conducted. A total of 852 candidates (146 PSC) were waitlisted of whom 609 (71.5%) underwent LTx and 159 (18.7%) died before transplantation. None of the ME PSC patients died, and they had a higher probability of LTx than LM PSC [HR obtained by considering ME as a time‐dependent covariate (HRME 9.86; 95% CI 6.14–15.85)] and ME non‐PSC patients (HRME 4.60; 95% CI 3.78–5.61). After liver transplantation, PSC patients alive at 3 years of follow‐up had a higher probability of relisting than non‐PSC patients (HR 7.94; 95% CI 1.98–31.85) but a significantly lower mortality (HR 0.51; 95% CI 0.27–0.95). In conclusion, current LTx prioritization advantages PSC patients on the LTx waiting list. Receiving ME points is strongly associated with timely LTx.</description><identifier>ISSN: 0934-0874</identifier><identifier>EISSN: 1432-2277</identifier><identifier>DOI: 10.1111/tri.13097</identifier><identifier>PMID: 29150966</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Cholangitis ; Cholangitis, Sclerosing - surgery ; exception points ; Female ; Graft Survival ; Health Policy ; Humans ; Liver ; Liver diseases ; Liver Failure - surgery ; Liver transplantation ; Liver Transplantation - methods ; Liver transplants ; Male ; Middle Aged ; Mortality ; Netherlands ; Patients ; Primary sclerosing cholangitis ; Probability ; Retrospective Studies ; Risk Assessment ; Time Factors ; Tissue and Organ Procurement - methods ; Tissue Donors ; Transplantation ; Transplants & implants ; waiting list mortality ; Waiting Lists</subject><ispartof>Transplant international, 2018-06, Vol.31 (6), p.590-599</ispartof><rights>2017 Steunstichting ESOT</rights><rights>2017 Steunstichting ESOT.</rights><rights>Copyright © 2018 Steunstichting ESOT. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3887-4918e60fae4a75d8e65f79b8193a6ab5ba9822190172d331db714efde97dd9f63</citedby><cites>FETCH-LOGICAL-c3887-4918e60fae4a75d8e65f79b8193a6ab5ba9822190172d331db714efde97dd9f63</cites><orcidid>0000-0002-7203-8126 ; 0000-0003-4746-0613 ; 0000-0001-8307-3341 ; 0000-0002-3096-4893 ; 0000-0001-6527-764X ; 0000-0002-1932-7412 ; 0000-0002-6054-569X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftri.13097$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftri.13097$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29150966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goet, Jorn C.</creatorcontrib><creatorcontrib>Hansen, Bettina E.</creatorcontrib><creatorcontrib>Tieleman, Madelon</creatorcontrib><creatorcontrib>Hoek, Bart</creatorcontrib><creatorcontrib>Berg, Aad P.</creatorcontrib><creatorcontrib>Polak, Wojciech G.</creatorcontrib><creatorcontrib>Dubbeld, Jeroen</creatorcontrib><creatorcontrib>Porte, Robert J.</creatorcontrib><creatorcontrib>Konijn‐Janssen, Cynthia</creatorcontrib><creatorcontrib>Man, Robert A.</creatorcontrib><creatorcontrib>Metselaar, Herold J.</creatorcontrib><creatorcontrib>Vries, Annemarie C.</creatorcontrib><title>Current policy for allocation of donor livers in the Netherlands advantages primary sclerosing cholangitis patients on the liver transplantation waiting list—a retrospective study</title><title>Transplant international</title><addtitle>Transpl Int</addtitle><description>Summary
Studies from the USA and Nordic countries indicate primary sclerosing cholangitis (PSC) patients have low mortality on the liver transplantation (LTx) waiting list. However, this may vary among geographical areas. Therefore, we compared waiting list mortality and post‐transplant survival between laboratory model for end‐stage liver disease (LM) and MELD exception (ME)‐prioritized PSC and non‐PSC candidates in a nationwide study in the Netherlands. A retrospective analysis of patients waitlisted from 2006 to 2013 was conducted. A total of 852 candidates (146 PSC) were waitlisted of whom 609 (71.5%) underwent LTx and 159 (18.7%) died before transplantation. None of the ME PSC patients died, and they had a higher probability of LTx than LM PSC [HR obtained by considering ME as a time‐dependent covariate (HRME 9.86; 95% CI 6.14–15.85)] and ME non‐PSC patients (HRME 4.60; 95% CI 3.78–5.61). After liver transplantation, PSC patients alive at 3 years of follow‐up had a higher probability of relisting than non‐PSC patients (HR 7.94; 95% CI 1.98–31.85) but a significantly lower mortality (HR 0.51; 95% CI 0.27–0.95). In conclusion, current LTx prioritization advantages PSC patients on the LTx waiting list. Receiving ME points is strongly associated with timely LTx.</description><subject>Adult</subject><subject>Cholangitis</subject><subject>Cholangitis, Sclerosing - surgery</subject><subject>exception points</subject><subject>Female</subject><subject>Graft Survival</subject><subject>Health Policy</subject><subject>Humans</subject><subject>Liver</subject><subject>Liver diseases</subject><subject>Liver Failure - surgery</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - methods</subject><subject>Liver transplants</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Netherlands</subject><subject>Patients</subject><subject>Primary sclerosing cholangitis</subject><subject>Probability</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Time Factors</subject><subject>Tissue and Organ Procurement - methods</subject><subject>Tissue Donors</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>waiting list mortality</subject><subject>Waiting Lists</subject><issn>0934-0874</issn><issn>1432-2277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAQgC0EokvhwAsgS1zgkNY_SRwf0aqFShVIqJwjJ55sXXnjYDut9sZD9FV4IZ6E2c3CAQkfbMv-_M14hpDXnJ1xHOc5ujMumVZPyIqXUhRCKPWUrJiWZcEaVZ6QFyndMcZEU7Hn5ERoXjFd1yvycz3HCGOmU_Cu39EhRGq8D73JLow0DNSGEc-8u4eYqBtpvgX6GXCO3ow2UWPvzZjNBhKdotuauKOp9xBDcuOG9rcBsY3LDq_RiaESDYvl4KQ5mjFNfu84hHwwCONL71L-9ePR0AgZZRP0GXma8mx3L8mzwfgEr47rKfl2eXGz_lRcf_l4tf5wXfSyaVRRat5AzQYDpVGVxX01KN01XEtTm67qjG6E4JpxJayU3HaKlzBY0MpaPdTylLxbvFMM32dIud261IPHbCHMqeVYQyErVu_Rt_-gd2GOI2bXCiYVK2tVNki9X6gev5QiDO2xZi1n7b6XLfayPfQS2TdH49xtwf4l_zQPgfMFeHAedv83tTdfrxblb7psruw</recordid><startdate>201806</startdate><enddate>201806</enddate><creator>Goet, Jorn C.</creator><creator>Hansen, Bettina E.</creator><creator>Tieleman, Madelon</creator><creator>Hoek, Bart</creator><creator>Berg, Aad P.</creator><creator>Polak, Wojciech G.</creator><creator>Dubbeld, Jeroen</creator><creator>Porte, Robert J.</creator><creator>Konijn‐Janssen, Cynthia</creator><creator>Man, Robert A.</creator><creator>Metselaar, Herold J.</creator><creator>Vries, Annemarie C.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7203-8126</orcidid><orcidid>https://orcid.org/0000-0003-4746-0613</orcidid><orcidid>https://orcid.org/0000-0001-8307-3341</orcidid><orcidid>https://orcid.org/0000-0002-3096-4893</orcidid><orcidid>https://orcid.org/0000-0001-6527-764X</orcidid><orcidid>https://orcid.org/0000-0002-1932-7412</orcidid><orcidid>https://orcid.org/0000-0002-6054-569X</orcidid></search><sort><creationdate>201806</creationdate><title>Current policy for allocation of donor livers in the Netherlands advantages primary sclerosing cholangitis patients on the liver transplantation waiting list—a retrospective study</title><author>Goet, Jorn C. ; Hansen, Bettina E. ; Tieleman, Madelon ; Hoek, Bart ; Berg, Aad P. ; Polak, Wojciech G. ; Dubbeld, Jeroen ; Porte, Robert J. ; Konijn‐Janssen, Cynthia ; Man, Robert A. ; Metselaar, Herold J. ; Vries, Annemarie C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3887-4918e60fae4a75d8e65f79b8193a6ab5ba9822190172d331db714efde97dd9f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Cholangitis</topic><topic>Cholangitis, Sclerosing - surgery</topic><topic>exception points</topic><topic>Female</topic><topic>Graft Survival</topic><topic>Health Policy</topic><topic>Humans</topic><topic>Liver</topic><topic>Liver diseases</topic><topic>Liver Failure - surgery</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - methods</topic><topic>Liver transplants</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Netherlands</topic><topic>Patients</topic><topic>Primary sclerosing cholangitis</topic><topic>Probability</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Time Factors</topic><topic>Tissue and Organ Procurement - methods</topic><topic>Tissue Donors</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><topic>waiting list mortality</topic><topic>Waiting Lists</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goet, Jorn C.</creatorcontrib><creatorcontrib>Hansen, Bettina E.</creatorcontrib><creatorcontrib>Tieleman, Madelon</creatorcontrib><creatorcontrib>Hoek, Bart</creatorcontrib><creatorcontrib>Berg, Aad P.</creatorcontrib><creatorcontrib>Polak, Wojciech G.</creatorcontrib><creatorcontrib>Dubbeld, Jeroen</creatorcontrib><creatorcontrib>Porte, Robert J.</creatorcontrib><creatorcontrib>Konijn‐Janssen, Cynthia</creatorcontrib><creatorcontrib>Man, Robert A.</creatorcontrib><creatorcontrib>Metselaar, Herold J.</creatorcontrib><creatorcontrib>Vries, Annemarie C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goet, Jorn C.</au><au>Hansen, Bettina E.</au><au>Tieleman, Madelon</au><au>Hoek, Bart</au><au>Berg, Aad P.</au><au>Polak, Wojciech G.</au><au>Dubbeld, Jeroen</au><au>Porte, Robert J.</au><au>Konijn‐Janssen, Cynthia</au><au>Man, Robert A.</au><au>Metselaar, Herold J.</au><au>Vries, Annemarie C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Current policy for allocation of donor livers in the Netherlands advantages primary sclerosing cholangitis patients on the liver transplantation waiting list—a retrospective study</atitle><jtitle>Transplant international</jtitle><addtitle>Transpl Int</addtitle><date>2018-06</date><risdate>2018</risdate><volume>31</volume><issue>6</issue><spage>590</spage><epage>599</epage><pages>590-599</pages><issn>0934-0874</issn><eissn>1432-2277</eissn><abstract>Summary
Studies from the USA and Nordic countries indicate primary sclerosing cholangitis (PSC) patients have low mortality on the liver transplantation (LTx) waiting list. However, this may vary among geographical areas. Therefore, we compared waiting list mortality and post‐transplant survival between laboratory model for end‐stage liver disease (LM) and MELD exception (ME)‐prioritized PSC and non‐PSC candidates in a nationwide study in the Netherlands. A retrospective analysis of patients waitlisted from 2006 to 2013 was conducted. A total of 852 candidates (146 PSC) were waitlisted of whom 609 (71.5%) underwent LTx and 159 (18.7%) died before transplantation. None of the ME PSC patients died, and they had a higher probability of LTx than LM PSC [HR obtained by considering ME as a time‐dependent covariate (HRME 9.86; 95% CI 6.14–15.85)] and ME non‐PSC patients (HRME 4.60; 95% CI 3.78–5.61). After liver transplantation, PSC patients alive at 3 years of follow‐up had a higher probability of relisting than non‐PSC patients (HR 7.94; 95% CI 1.98–31.85) but a significantly lower mortality (HR 0.51; 95% CI 0.27–0.95). In conclusion, current LTx prioritization advantages PSC patients on the LTx waiting list. Receiving ME points is strongly associated with timely LTx.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>29150966</pmid><doi>10.1111/tri.13097</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7203-8126</orcidid><orcidid>https://orcid.org/0000-0003-4746-0613</orcidid><orcidid>https://orcid.org/0000-0001-8307-3341</orcidid><orcidid>https://orcid.org/0000-0002-3096-4893</orcidid><orcidid>https://orcid.org/0000-0001-6527-764X</orcidid><orcidid>https://orcid.org/0000-0002-1932-7412</orcidid><orcidid>https://orcid.org/0000-0002-6054-569X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Cholangitis Cholangitis, Sclerosing - surgery exception points Female Graft Survival Health Policy Humans Liver Liver diseases Liver Failure - surgery Liver transplantation Liver Transplantation - methods Liver transplants Male Middle Aged Mortality Netherlands Patients Primary sclerosing cholangitis Probability Retrospective Studies Risk Assessment Time Factors Tissue and Organ Procurement - methods Tissue Donors Transplantation Transplants & implants waiting list mortality Waiting Lists |
| title | Current policy for allocation of donor livers in the Netherlands advantages primary sclerosing cholangitis patients on the liver transplantation waiting list—a retrospective study |
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