Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective

<b>Background:</b> The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the tim...

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Autores principales:	Hui-Ying Lin, Cheng-Maw Ho, Pei-Yin Hsieh, Min-Heuy Lin, Yao-Ming Wu, Ming-Chih Ho, Po-Huang Lee, Rey-Heng Hu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	live donor liver transplantation intend to donate root cause risk factor Medicine R
Acceso en línea:	https://doaj.org/article/7edb1730683848948fd704c8b9d0b432
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spelling	oai:doaj.org-article:7edb1730683848948fd704c8b9d0b4322021-11-25T18:07:46ZCircuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective10.3390/jpm111111732075-4426https://doaj.org/article/7edb1730683848948fd704c8b9d0b4322021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1173https://doaj.org/toc/2075-4426<b>Background:</b> The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. <b>Methods:</b> In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. <b>Results:</b> From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0–58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0–188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient’s critical illness, donor’s physical conditions, motivation for live donation, and stable condition while on the waiting list. <b>Conclusions:</b> Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process.Hui-Ying LinCheng-Maw HoPei-Yin HsiehMin-Heuy LinYao-Ming WuMing-Chih HoPo-Huang LeeRey-Heng HuMDPI AGarticlelive donor liver transplantationintend to donateroot causerisk factorMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1173, p 1173 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	live donor liver transplantation intend to donate root cause risk factor Medicine R
spellingShingle	live donor liver transplantation intend to donate root cause risk factor Medicine R Hui-Ying Lin Cheng-Maw Ho Pei-Yin Hsieh Min-Heuy Lin Yao-Ming Wu Ming-Chih Ho Po-Huang Lee Rey-Heng Hu Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
description	<b>Background:</b> The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. <b>Methods:</b> In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. <b>Results:</b> From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0–58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0–188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient’s critical illness, donor’s physical conditions, motivation for live donation, and stable condition while on the waiting list. <b>Conclusions:</b> Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process.
format	article
author	Hui-Ying Lin Cheng-Maw Ho Pei-Yin Hsieh Min-Heuy Lin Yao-Ming Wu Ming-Chih Ho Po-Huang Lee Rey-Heng Hu
author_facet	Hui-Ying Lin Cheng-Maw Ho Pei-Yin Hsieh Min-Heuy Lin Yao-Ming Wu Ming-Chih Ho Po-Huang Lee Rey-Heng Hu
author_sort	Hui-Ying Lin
title	Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_short	Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_full	Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_fullStr	Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_full_unstemmed	Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
title_sort	circuitous path to live donor liver transplantation from the coordinator’s perspective
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7edb1730683848948fd704c8b9d0b432
work_keys_str_mv	AT huiyinglin circuitouspathtolivedonorlivertransplantationfromthecoordinatorsperspective AT chengmawho circuitouspathtolivedonorlivertransplantationfromthecoordinatorsperspective AT peiyinhsieh circuitouspathtolivedonorlivertransplantationfromthecoordinatorsperspective AT minheuylin circuitouspathtolivedonorlivertransplantationfromthecoordinatorsperspective AT yaomingwu circuitouspathtolivedonorlivertransplantationfromthecoordinatorsperspective AT mingchihho circuitouspathtolivedonorlivertransplantationfromthecoordinatorsperspective AT pohuanglee circuitouspathtolivedonorlivertransplantationfromthecoordinatorsperspective AT reyhenghu circuitouspathtolivedonorlivertransplantationfromthecoordinatorsperspective
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Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective

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