Subjective Difficulty Scale in Liver Transplantation: A Prospective Observational Study

Kitano, Yuki; Pietrasz, Daniel; Fernandez-Sevilla, Elena; Golse, Nicolas; Vibert, Éric; Cunha, Antonio Sa; Azoulay, Daniel; Cherqui, Daniel; Baba, Hideo; Adam, René; Allard, Marc‐Antoine

doi:10.3389/ti.2022.10308

Cited by 4 publications

(1 citation statement)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this context, a comprehensive assessment of the intraoperative variables was conducted, mirroring the approach outlined by our group in Kitano's research referring to unselected patients, "Subjective Difficulty Scale in Liver Transplantation" [32]. The current study's findings indicates that in the meticulously chosen demographic for liver transplants with grafts from elderly donors, a transfusion requirement was the only intraoperative factor to be a statistically significant risk for survival.…”

Section: Interpretation With Reference To Other Studiesmentioning

confidence: 77%

Liver Transplantation from Elderly Donors (≥85 Years Old)

Romano,

Cano,

Pietrasz

et al. 2024

Cancers

Self Cite

View full text Add to dashboard Cite

Background: Despite the ongoing trend of increasing donor ages in liver transplantation (LT) setting, a notable gap persists in the availability of comprehensive guidelines for the utilization of organs from elderly donors. This study aimed to evaluate the viability of livers grafts from donors aged ≥85 years and report the post-LT outcomes compared with those from “ideal” donors under 40 years old. Methods: Conducted retrospectively at a single center from 2005 to 2023, this study compared outcomes of LTs from donors aged ≥85 y/o and ≤40 y/o, with the propensity score matching to the recipient’s gender, age, BMI, MELD score, redo-LT, LT indication, and cause of donor death. Results: A total of 76 patients received grafts from donors ≥85 y/o and were compared to 349 liver grafts from donors ≤40 y/o. Prior to PSM, the 5-year overall survival was 63% for the elderly group and 77% for the young group (p = 0.002). After PSM, the 5-year overall survival was 63% and 73% (p = 0.1). A nomogram, developed at the time of graft acceptance and including HCC features, predicted 10-year survival after LT using a graft from a donor aged ≥85. Conclusions: In the context of organ scarcity, elderly donors emerge as a partial solution. Nonetheless, without proper selection, LT using very elderly donors yields inferior long-term outcomes compared to transplantation from very young donors ≤40 y/o. The resulting nomogram based on pre-transplant criteria allows for the optimization of elderly donor/recipient matching to achieve satisfactory long-term results, in addition to traditional matching methods.

show abstract

Section: Interpretation With Reference To Other Studiesmentioning

confidence: 77%