Outcomes in liver transplantation: Does sex matter?

Sarkar, Monika; Watt, Kymberly D.; Terrault, Norah A.; Berenguer, Marina

doi:10.1016/j.jhep.2014.11.023

Cited by 90 publications

(99 citation statements)

References 135 publications

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“…Gender disparities in posttransplantation outcomes for adult females have previously been described with potential etiologies including poorer graft survival due to lower-quality grafts for women compared to men and a higher risk of posttransplantation renal impairment in females; though these variables were not available for analysis in our study. 31 …”

Section: Discussionmentioning

confidence: 99%

“… a Graft weight-to-recipient body weight ratio (GWBWR) < 0.8% where GWBWR = graft weight (kg)/recipient body weight (kg) 30,31 b BSA index (BSAi) < 0.78 where BSAi = BSA donor/BSA recipient 30,32 c BSAi > 1.24 30,32 …”

Section: Figurementioning

confidence: 99%

“… a Graft weight-to-recipient body weight ratio (GWBWR) < 0.8% where GWBWR = graft weight (kg)/recipient body weight (kg) 30,31 …”

Section: Figurementioning

confidence: 99%

See 2 more Smart Citations

Disparities in Waitlist and Posttransplantation Outcomes in Liver Transplant Registrants and Recipients Aged 18 to 24 Years

et al. 2017

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Background We evaluated liver transplantation waitlist and posttransplantation outcomes in 18–24 year olds compared to both younger (0–17 year old) and older (25–34 year old) registrants and recipients. Methods Utilizing national data from the United Network for Organ Sharing, competing risk, Cox regression and Kaplan-Meier analyses were performed on first-time liver transplant registrants (n=13,979) and recipients (n=8,718) ages 0–34 years old between 2002 to 2015. Results Among nonStatus 1A registrants, both 0–17 and 25–34 year olds were less likely to experience drop-out from the waiting list compared to 18–24 year olds (adjusted hazard ratio [AHR] 0–5 year olds=0.36, 6–11=0.29, 12–17=0.48, 18–24=1.00, 25–34=0.82). Although there was no difference in risk of graft failure across all age groups, both younger and older age groups had significantly lower risk of posttransplant mortality compared to 18–24 year olds (AHR for 0–5 year olds=0.53, 6–11=0.48, 12–17=0.70, 18–24=1.00, 25–34=0.77). This may be related to lower likelihood of re-transplantation after graft failure in 18–24 year olds. Conclusions This national registry study demonstrates for the first time poorer waitlist and postliver transplant outcomes in young adults ages 18–24 years at the time of listing and transplantation compared to older and younger age groups. Given the potential survival benefit in transplanting young adults and the shortage of solid organs for transplant, future studies are critical to identify and target modifiable risk factors to improve waitlist and long-term posttransplant outcomes in 18–24 year old registrants and recipients.

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Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

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Disparities in Waitlist and Posttransplantation Outcomes in Liver Transplant Registrants and Recipients Aged 18 to 24 Years

et al. 2017

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“…39 Sexual functioning after transplantation has become a very important parameter in evaluating QOL in organ transplant recipients. 40 Overall, a significant improvement of sexual function after transplantation has been shown in most studies, the improvement being similar in alcohol-related versus nonalcohol-related LT recipients.…”

Section: Quality Of Life After Lt In Patients Transplanted Formentioning

confidence: 83%

Liver Transplantation for Alcoholic Liver Disease

et al. 2016

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Alcohol-related liver disease is the second most frequent indication for liver transplantation (LT), yet as many as 90% to 95% of patients with alcohol-related end-stage liver disease are never formally evaluated for LT. Furthermore, despite its significance as a cause of chronic liver disease and indication for LT, it has received little attention in recent years for several reasons, including the good posttransplant short-term results, and the lack of specific "drugs" used for this disease. A writing group, endorsed by the International Liver Transplant Society, was convened to write guidelines on Liver Transplantation for Alcoholic Liver Disease to summarize current knowledge and provide answers to controversial and delicate ethical as well as clinical problems. We report here a short version of the guidelines (long version available at www.ilts.org) with the final recommendations graded for level of evidence. The writing group membership is expected to remain active for 5 years, reviewing the guideline annually, and updating the online version when appropriate.

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“…Longer waitlist times necessitate more careful treatment to minimize the risk of removal from the waitlist for relapse to drinking. Post-transplant, there is evidence of increased relapse rates and poorer psychosocial outcomes in women(31), highlighting the particular need for ongoing relapse prevention treatment in this group.…”

Section: Role Of Liver Transplantation In Treating End-stage Liver DImentioning

confidence: 99%

Management of Alcohol Use Disorder in Patients Requiring Liver Transplant

Lee

Leggio

2015

AJP

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Alcoholic liver disease is the second most common indication for orthotopic liver transplantation in western countries. The majority of patients with alcoholic liver disease, however, are not referred for transplant evaluation. If evaluated, a 6 month period of sobriety is required before waitlisting for transplant. The consequences of relapse to alcohol use in patients on the waitlist are usually removal from the list. Therefore, identification and treatment of alcohol use disorder in patients with end-stage liver disease greatly impacts quality of life, treatment options and survival in patients’ course with this grave illness. Psychosocial and behavioral interventions prior to transplant appear to reduce drinking in the period before the surgery as well as reduce relapse rates post-transplant. Only one of the three medications approved by the Food and Drug Administration, acamprosate, seems feasible for use in patients with end-stage liver disease, while several other medications currently under investigation for the treatment of alcohol use disorder can be considered for use in this population. While only baclofen has been formally studied in alcoholic patients with end-stage liver disease with positive results for safety and efficacy, other medications also hold promise to treat alcohol use disorder in this population. Transplant programs with addictions specialists who function as an integral part of the treatment team may offer better outcomes to patients in terms of success of maintaining sobriety both pre- and post-transplant.

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Outcomes in liver transplantation: Does sex matter?

Cited by 90 publications

References 135 publications

Disparities in Waitlist and Posttransplantation Outcomes in Liver Transplant Registrants and Recipients Aged 18 to 24 Years

Disparities in Waitlist and Posttransplantation Outcomes in Liver Transplant Registrants and Recipients Aged 18 to 24 Years

Liver Transplantation for Alcoholic Liver Disease

Management of Alcohol Use Disorder in Patients Requiring Liver Transplant

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