18 February 2022: Original Paper
Impact on Waitlist Outcomes from Changes in the Medical Eligibility of Candidates for Simultaneous Liver-Kidney Transplantation Following Implementation of the 2017 Organ Procurement and Transplantation Network/United Network for Organ Sharing Policy in the United States
Shingo Shimada 1ADEF , Toshihiro Kitajima 1BCE , Yukiko Suzuki 1BD , Yasutaka Kuno 1BD , Tayseer Shamaa 1BC , Tommy Ivanics 1BCE , Kelly Collins 1DE , Michael Rizzari 1BD , Atsushi Yoshida 1BD , Marwan Abouljoud 1BD , Dilip Moonka 2BD , Shunji Nagai 1ACE*DOI: 10.12659/AOT.934850
Ann Transplant 2022; 27:e934850
Table 8 Transplanted patient characteristics at time of liver transplant alone between the eras.
| n (%) | Before the 2017 policyn=40 (42.1) | After the 2017 policyn=55 (57.9) | P value | |
|---|---|---|---|---|
| Recipient age (year), median [IQR] | 57.5 [49.7, 62.0] | 60.0 [50.0, 64.0] | 0.45 | |
| Recipient age group (year) (%) | 10 (25.0) | 13 (23.6) | 0.55 | |
| 50–59 | 13 (32.5) | 13 (23.6) | ||
| 60 or older | 17 (42.5) | 29 (52.7) | ||
| Recipient gender (%) | Male | 23 (57.5) | 28 (50.9) | 0.66 |
| Recipient ethnicity (%) | White | 25 (62.5) | 34 (61.8) | 0.91 |
| Black | 3 (7.5) | 3 (5.5) | ||
| Hispanic | 9 (22.5) | 15 (27.3) | ||
| Others | 3 (7.5) | 3 (5.5) | ||
| Recipient BMI, median [IQR] | 26.4 [24.2, 31.7] | 27.3 [23.6, 30.8] | 1.00 | |
| Moderate/severe ascites at LTA (%) | 26 (65.0) | 22 (40.0) | 0.02 | |
| Dialysis at LTA(%) | 25 (62.5) | 31 (56.4) | 0.69 | |
| Grade 3/4 encephalopathy at LTA(%) | 9 (22.5) | 8 (14.5) | 0.46 | |
| Mechanically ventilated at LTA(%) | 13 (32.5) | 13 (23.6) | 0.46 | |
| MELD score at LTA | 35.0 [30.0, 39.2] | 34.0 [21.0, 39.5] | 0.43 | |
| MELD score group (%) | 6–29 | 9 (22.5) | 20 (36.4) | 0.29 |
| 30–34 | 11 (27.5) | 10 (18.2) | ||
| 35+ | 20 (50.0) | 25 (45.5) | ||
| Portal vein thrombosis at LTA (%) | 11 (27.5) | 5 (9.1) | 0.03 | |
| Waiting time (day) | 23.0 [13.5, 64.0] | 33.0 [8.5, 99.0] | 0.55 | |
| eGFR at LTA (ml/min) | 26.2 [14.9, 48.0] | 33.8 [16.1, 62.7] | 0.33 | |
| Serum creatinine at LTA (mg/dL), median [IQR] | 2.1 [1.5, 3.8] | 1.8 [1.1, 3.1] | 0.25 | |
| Serum total bilirubin at LTA (mg/dL), median [IQR] | 6.0 [2.4, 16.4] | 6.5 [2.3, 18.4] | 0.90 | |
| PT-INR at LTA, median [IQR] | 2.1 [1.7, 2.6] | 1.8 [1.5, 2.3] | 0.11 | |
| Serum sodium at LTA (mEq/L), median [IQR] | 136.0 [134.7, 137.2] | 137.0 [134.0, 138.0] | 0.44 | |
| Serum sodium group (mEq/L) (%) | 10 (25.0) | 15 (27.3) | 0.92 | |
| 135–144 | 18 (70.0) | 38 (69.1) | ||
| 145 or higher | 2 (5.0) | 2 (3.6) | ||
| Donor age (year), median [IQR] | 35.0 [25.0, 54.0] | 38.0 [27.0, 51.5] | 0.52 | |
| Donor age group (year) (%) | 26 (65.0) | 29 (52.7) | 0.29 | |
| 40–59 | 8 (20.0) | 19 (34.5) | ||
| 60 or older | 6 (15.0) | 7 (12.7) | ||
| Donor gender (%) | Male | 24 (60.0) | 30 (54.5) | 0.74 |
| Donor BMI, median [IQR] | 27.2 [23.4, 31.1] | 26.7 [22.4, 31.6] | 0.60 | |
| Donor ethnicity (%) | White | 22 (55.0) | 33 (60.0) | 0.69 |
| Black | 8 (20.0) | 7 (12.7) | ||
| Hispanic | 8 (20.0) | 10 (18.2) | ||
| Others | 2 (5.0) | 5 (9.1) | ||
| Cold ischemia time (hr), median [IQR] | 6.6 [4.9, 8.0] | 5.9 [4.6, 7.2] | 0.20 | |
| Donation after circulatory death (%) | 1 (2.5) | 4 (7.3) | 0.57 | |
| Share type (%) | Local | 25 (62.5) | 27 (49.1) | 0.17 |
| Regional | 14 (35.0) | 28 (50.9) | ||
| National | 1 (2.5) | 0 (0) | ||
| Data was summarized using the median with interquartile range (IQR) for continuous variables and using percentage for discrete variables. Continuous variables were analyzed using the Mann Whitney-U test and discrete variables were analyzed using a chi-square test. BMI – body mass index; eGFR – estimated glomerular filtration rate; LTA – liver transplant alone; MELD – model for end-stage liver disease; PT-INR – prothrombin time-international normalized ratio. | ||||