Influence of Blood Group on Mortality and Waiting Time Before Heart Transplantation in the United Kingdom: Implications for Equity of Access

Hussey, J.C.; Parameshwar, Jayan; Banner, Nicholas R.

doi:10.1016/j.healun.2006.10.012

Cited by 13 publications

(15 citation statements)

References 14 publications

(13 reference statements)

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“…Several prior studies assessing waiting times for solid-organ transplantation [1][2][3][4][5][6][7][8] have revealed a common and concerning pattern: recipients of blood type O wait on average substantially longer than blood type A, while those of blood type A in turn wait longer than patients with blood type AB. The waiting times for patients with blood type B are sometimes somewhat longer than type O, although this observation is inconsistent [1][2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…The waiting times for patients with blood type B are sometimes somewhat longer than type O, although this observation is inconsistent [1][2][3][4][5][6][7][8]. This waiting time pattern for solid-organ transplantation arises in many countries and/or health-systems, seemingly regardless of organ type.…”

Section: Introductionmentioning

confidence: 99%

“…A list of countries and organ types that illustrates their diversity follows: Rexius et al [7] [hearts in Sweden], Hussey et al [4] [hearts in the UK], Barone et al [1] [kidneys in the US] and Phelan et al [6] [kidneys in Ireland]. In short, the blood type O problem occurs for numerous organ types in numerous jurisdictions, with, of course, differences in degree of disparity in waiting times.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A queuing model to address waiting time inconsistency in solid-organ transplantation

Stanford

Lee

Chandok

et al. 2014

Operations Research for Health Care

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a b s t r a c tOrgan transplantation is a vital therapy for the treatment of many patients. Due to blood compatibility rules, there has been a pattern in many jurisdictions for differing organ types where recipients of blood type O experience longer waiting times than those of other blood types, partly due to crosstransplantation of too many O organs to compatible donors of other blood types. In response to this, a recent development in some jurisdictions is a change in the rules to insist upon ABO-identical transplantation. The literature review herein enables us to conclude that unrestricted cross-transplantation has not achieved equity of access across all blood groups in any jurisdiction in which the problem has arisen. The present study next shows that ABO identical transplantation cannot achieve equity, either. It then presents a model for restricted cross-transplantation which indicates how comparable waiting times for all blood types could be achieved.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A queuing model to address waiting time inconsistency in solid-organ transplantation

Stanford

Lee

Chandok

et al. 2014

Operations Research for Health Care

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“…27 When the INTERMACS registry did not report the required data, results from studies on HeartMate II patients were used. 28 Table II in the online-only Data Supplement summarizes the characteristic of studies selected.…”

Section: Outcome Probability Datamentioning

confidence: 99%

Cost-Effectiveness of Ventricular Assist Device Therapy as a Bridge to Transplantation Compared With Nonbridged Cardiac Recipients

Alba

Delgado

et al. 2013

Circulation

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Background-Current available treatment options for advanced heart failure include heart transplantation and ventricular assist device (VAD) therapy. This project aimed to evaluate the cost-effectiveness of a bridge-to-transplantation (BTT)-VAD approach relative to direct heart transplantation in transplant-eligible patients. Methods and Results-A Markov model was used to evaluate survival benefits and costs for BTT-VAD versus nonbridged heart transplant recipients. Three different scenarios were considered according to severity of patients' baseline hemodynamic status (high, medium, and low risk). Results are presented in terms of survival, costs, and cost-effectiveness ratio. Sensitivity analyses were used to analyze uncertainty in model estimates. Over a 20-year time horizon, BTT-VAD therapy increased survival at an increased cost relative to nonbridged heart transplant recipients: $100 841more in costs and 1.19 increased life years (LYs) in high-risk patients ($84 964/LY), $112 779 more in costs and 1.14 more LYs ($99 039/LY) in medium-risk patients, and an additional cost of $144 334 and incremental clinical benefit of 1.21 more LYs ($119 574/LY) in low-risk patients. The sensitivity analysis estimated a 59%, 54%, and 43% chance of BTT-VAD therapy being cost-effective for high-, medium-, and low-risk patients at a willingness-to-pay level of $100 000/LY. Subgroup analyses indicated that risk of post-VAD and transplantation complications, waiting time, renal dysfunction, and patient age substantially affected the cost-effectiveness ratio. Conclusions-BTT-VAD therapy is associated with improved survival and increased costs. On the basis of commonlyaccepted willingness-to-pay thresholds, BTT-VAD therapy is likely to be cost-effective relative to nonbridged heart transplantation in specific circumstances. (Circulation. 2013;127:2424-2435.)Key Words: cost-benefit analysis ◼ economics ◼ heart-assist devices ◼ heart failure ◼ heart transplantation © 2013 American Heart Association, Inc.

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“…A sample of these studies follows which gives an indication of the variety of contexts in which this problem has been recognized: kidneys in Germany (Glander et al [7] and Liefeldt et al [18]), hearts in the UK (Hussey et al [9]), kidneys in the US (Zenios et al [29]), and livers in the US (Barone et al [2]) and in Canada (Stanford et al [21]). …”

Section: Introductionmentioning

confidence: 99%

A model for deceased-donor transplant queue waiting times

et al. 2014

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In many jurisdictions, organ allocation is done on the basis of the health status of the patient, either explicitly or implicitly. This paper presents a self-promoting priority queueing model for patient waiting times which takes into account changes in health status over time. In this model, most patients arrive as "regular" customers to the queue, but as the health of a patient degrades, their status is promoted to "priority" to reflect the increased urgency of the transplant. We model the queueing system as a level-dependent quasi-birth-and-death process, and the steady-state joint queue length distribution as well as the marginal delay distributions for each queue are computed via the use of matrix analytic techniques. The model is calibrated using liver transplantation wait-list data, provided by a regional health centre in Canada, that tracked approximately 1,100 patients over nearly 13 years. Blood-type specific models are fit and performance measures, such as the mean and distribution of the time until transplant, are obtained and compared to empirical estimates calculated using the raw data.

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Influence of Blood Group on Mortality and Waiting Time Before Heart Transplantation in the United Kingdom: Implications for Equity of Access

Cited by 13 publications

References 14 publications

A queuing model to address waiting time inconsistency in solid-organ transplantation

A queuing model to address waiting time inconsistency in solid-organ transplantation

Cost-Effectiveness of Ventricular Assist Device Therapy as a Bridge to Transplantation Compared With Nonbridged Cardiac Recipients

A model for deceased-donor transplant queue waiting times

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