https://scholars.lib.ntu.edu.tw/handle/123456789/604560
標題: | Circuitous Path to Live Donor Liver Transplantation from the Coordinator's Perspective | 作者: | Lin, Hui-Ying CHENG-MAW HO Hsieh, Pei-Yin Lin, Min-Heuy YAO-MING WU MING-CHIH HO PO-HUANG LEE REY-HENG HU |
關鍵字: | intend to donate; live donor liver transplantation; risk factor; root cause | 公開日期: | 10-十一月-2021 | 出版社: | MDPI | 卷: | 11 | 期: | 11 | 來源出版物: | Journal of personalized medicine | 摘要: | Background: The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators' perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. Methods: In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. Results: From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0-58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0-188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient's critical illness, donor's physical conditions, motivation for live donation, and stable condition while on the waiting list. Conclusions: Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/604560 | ISSN: | 2075-4426 | DOI: | 10.3390/jpm11111173 |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。