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Outcomes of pediatric liver retransplantation candidates in the modern era: Strategies are needed to avoid waitlist mortality in the United States.
Liver Transpl
January 2025
Division of Transplantation, Department of Surgery, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA.
Pediatric liver retransplantation (rLT) has historically shown poorer outcomes compared to primary liver transplantation (pLT). Comprehensive studies assessing outcomes for pediatric rLT candidates under the modern allocation policy are lacking. OPTN data from January 1, 2010, to December 31, 2022 were obtained; exclusion criteria included candidates ≥18years of age and those listed or transplanted for multiple organs.
View Article and Find Full Text PDFTailoring Kidney Transplant Strategies: Unraveling the Impact of Acute Kidney Injury and Preservation Methods Across Different Strata of Kidney Risk.
Clin Transplant
January 2025
Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA.
Background: The use of donor kidneys with acute kidney injury (AKI) aims to expand the organ pool, but uncertainty remains regarding their outcomes across different Kidney Donor Profile Index (KDPI) groups and preservation methods.
Methods: We retrospectively analyzed 108 160 deceased donor kidney transplants from the OPTN database, focusing on adult recipients of kidneys from donors with or without AKI between December 2014 and December 2022. Propensity matching was used for each KDPI group (1-20, 21-59, 60-84, and 85-100), comparing donors with AKIN stages 0-1 to AKIN stages 2-3.
The Hepatitis C Virus "Penalty": Is Removing Donor Hepatitis C Status From the Kidney Donor Profile Index Calculation Enough?
Transplantation
October 2024
Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, WA.
Simultaneous Liver and Kidney Transplantation in Patients Aged 70 y and Older: Proceed With Caution.
Transplant Direct
August 2024
Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, WA.
Article Synopsis
- The number of elderly patients (70 years and older) requiring dual organ transplants, specifically liver and kidney, is on the rise due to metabolic liver diseases, but data on their outcomes remains scarce since the introduction of the simultaneous liver and kidney (SLK) policy.
- A study analyzed the outcomes of SLK versus kidney-only transplants among adults, showing that elderly patients had significantly lower survival rates and graft survival compared to younger age groups, with a marked increase in SLK transplants from 2017 to 2021.
- Despite the poorer outcomes for older recipients, the study concludes that age should not be the sole factor in deciding whether to proceed with transplantation; alternatives like sequential kidney transplantation after liver transplant should be explored to enhance
Evaluating the Correlation Between Anteroposterior Diameter, Body Surface Area, and Height for Liver Transplant Donors and Recipients.
Transplant Direct
June 2024
Department of Surgery, Clinical and Bio-Analytics Transplant Laboratory (CBATL), University of Washington, Seattle, WA.
Background: Small stature and female sex correlate to decreased deceased donor liver transplant (DDLT) access and higher waitlist mortality. However, efforts are being made to improve access and equity of allocation under the new continuous distribution (CD) system. Liver anteroposterior diameter (APD) is a method used by many centers to determine size compatibility for DDLT but is not recorded systematically, so it cannot be used for allocation algorithms.
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