Benefit was most evident in wait-listed cirrhosis patients with moderate-to-severe frailty
By Lori Solomon HealthDay Reporter
WEDNESDAY, Oct. 11, 2023 (HealthDay News) — High-risk cirrhosis patients awaiting liver transplant (LT) most benefit from potential living donors, according to a study published online Sept. 2 in Aging.
Fakhar Ali Qazi Arisar, M.B.B.S., from the University of Toronto, and colleagues evaluated the impact of access to living donor liver transplantation (LDLT) in wait-listed patients at highest risk for dropout. The analysis included 860 adult patients with decompensated cirrhosis listed for LT from November 2012 to December 2018.
The researchers found that 41.8 percent had a potential living donor identified and 57.6 percent underwent LT, 34.2 percent of which were LDLT. The benefit of a potential living donor was most evident for patients with moderate-to-severe frailty at listing, height <160 cm, and Model for End-Stage Liver Disease (MELD)-Na score <20. Patients at highest risk for dropout while waiting for a deceased donor most benefited from a potential living donor (time-dependent area under the receiver operating characteristic curve, 0.82).
“Our study identifies that certain patient subgroups (short stature, MELD <20, and moderate-to-severe frailty) are at the highest risk for waitlist mortality with prolonged waiting time for a deceased donor organ offer," the authors write. "These patient subgroups, which represent a growing share of the waitlist population in recent years, would be especially protected against death or delisting if they had access to living donation at the time of listing. Certainly, LDLT is beneficial to all, with improved waitlist mortality and posttransplant outcomes."
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