Live liver donors’ risk thresholds: risking a life to save a life

Molinari, Michele; Matz, Jacob; DeCoutere, Sarah; Eltawil, Karim M.; Abu-Wasel, Bassam; Keough, Valerie

doi:10.1111/hpb.12192

Cited by 16 publications

(20 citation statements)

References 123 publications

(200 reference statements)

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“…Third, uncertainty surrounding wait‐list time can make it difficult to plan other aspects of one's life such as travel . And finally, greater understanding about wait‐list time may impact medical decision‐making such as the role and benefit for living donation . Given these uncertainties, some limited evidence exists that stress in the pretransplant period can be reduced through increased education and preparation about what to expect in this phase of care, although the ability to reduce stress has not been consistently demonstrated .…”

Section: Discussionmentioning

confidence: 99%

Predicting chance of liver transplantation for pediatric wait‐list candidates

Luo

Mogul

Massie

et al. 2019

Pediatric Transplantation

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Information about wait‐list time has been reported as one of the single most frequently asked questions by individuals awaiting a transplant but data regarding wait‐list time have not been processed in a useful way for pediatric candidates. To predict chance of receiving a DDLT, we identified 6471 pediatric (<18 years), non status‐1A, liver‐only transplant candidates between 2006 and 2017 from the SRTR. Cox regression with shared frailty for DSA level effect was used to model the association of blood type, weight, allocation PELD and MELD, and DSA with chance of DDLT. Jackknife technique was used for validation. Median (interquartile range) wait‐list time was 100 (34‐309) days. Non‐O Blood type, higher PELD/MELD score at listing, and DSA were associated with increased chance of DDLT, while age 1‐5 years and 10‐18 years was associated with lower chance of DDLT (P < 0.001 for all variables). Our model accurately predicted chance of transplant (C‐statistic = 0.68) and was able to predict DDLT at specific follow‐up times (eg, 3 months). This model can serve as the basis for an online tool that would provide useful information for pediatric wait‐list candidates.

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Section: Discussionmentioning

confidence: 99%

Predicting chance of liver transplantation for pediatric wait‐list candidates

Luo

Mogul

Massie

et al. 2019

Pediatric Transplantation

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“…3-10 but studies on stem cell transplant 11,12 liver transplant 8,13 and lung transplant14 were also included. No studies focused on uncertainty of family members.…”

Section: Resultsmentioning

confidence: 99%

Uncertainty in Living-Donor Transplant Settings: a Review of the Literature

Hiratsuka¹

2017

NCOAJ

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“…25 Additionally, studies have reported that risk information is “not important in their decision [to donate]” 4 because they wished to save the recipient's life. 13,26 Although the sample was too small for sub-analyses, the donor's relationship to the recipient may have played a role in donors minimizing risks. A factor contributing to this pattern of ignoring “routine” risks was donors' expressed familiarity with surgical risks.…”

Section: Discussionmentioning

confidence: 99%

Live liver donors’ information needs: A qualitative study of practical implications for informed consent

Gordon

Mullee

Skaro

et al. 2016

Surgery

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Background As live donor liver transplantation is increasingly used to expand the donor pool, concerns remain regarding ensuring live liver donors' informed consent. This study assessed donors' information preferences and perceptions of informed consent. Methods Cognitive interviews were conducted with donors by telephone about how knowledge items in a new survey instrument were material to informed consent, between November 2011 and April 2012. Thematic analysis was used to analyze qualitative data until reaching saturation. Results Twenty-nine liver donors participated (85% participation rate). Donors commonly reported being unable to understand or retain much information disclosed during education. Donors preferred information about major donation risks, e.g., death, and minor risks that would likely affect their daily lives, e.g., wound infection. Donors expressed less interest in information about their rights, confidentiality, or the medical procedure. Donors' preferences varied regarding statistical information. Many perceived the disclosure of risk information to be excessive, and rationalized risks believed to be uncommon or not serious. Donors were disappointed by the brevity of the post-donation hospital stay. Conclusions Our findings suggest that the complexity and volume of disclosed information during evaluation was difficult for donors to adequately comprehend. Donors' lack of appreciation for the seriousness of complications may undermine their ability to provide informed consent. Future research should develop effective information delivery methods to enhance informed consent.

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Live liver donors’ risk thresholds: risking a life to save a life

Abstract: Potential donors were risk takers and were willing to donate when given the opportunity. They accepted significant risks, especially if they had a close emotional relationship with the recipient.

Cited by 16 publications

References 123 publications

Predicting chance of liver transplantation for pediatric wait‐list candidates

Predicting chance of liver transplantation for pediatric wait‐list candidates

Uncertainty in Living-Donor Transplant Settings: a Review of the Literature

Live liver donors’ information needs: A qualitative study of practical implications for informed consent

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