BACKGROUND: Candidacy for liver transplantation is determined through standardized evaluation. There are limited data on the frequency and reasons for denial of transplantation after assessment; analysis may shed light on the short-term utility of the assessment. We sought to describe the frequency and reasons for ineligibility for liver transplantation among referred adults. METHODS: We studied all prospectively followed recipient candidates at a single centre who were deemed unsuitable for liver transplantation after assessment. Inclusion criteria were age 18 years and older and completion of a standard liver transplantation evaluation over a 3-year period. Patients were excluded if they had a history of prior assessment or liver transplantation within the study period. Demographic and baseline clinical data and reasons for recipient ineligibility were recorded. RESULTS: In all, 337 patients underwent their first liver transplantation evaluation during the study period; 166 (49.3%) fulfilled inclusion criteria. The mean age was 55.4 years, and 106 (63.9%) were men. The 3 most common reasons for denial of listing were patient too well (n = 82, 49.4%), medical comorbidities and/or need for medical optimization (n = 43, 25.9%) and need for addiction rehabilitation (n = 28, 16.9%). CONCLUSION: Ineligibility for transplantation after assessment was common, occurring in nearly half of the cohort. Most denied candidates could be identified with more discriminate screening before the resource-intensive assessment; however, the assessment likely provides unforeseen positive impacts on patient care.
BACKGROUND: Candidacy for liver transplantation is determined through standardized evaluation. There are limited data on the frequency and reasons for denial of transplantation after assessment; analysis may shed light on the short-term utility of the assessment. We sought to describe the frequency and reasons for ineligibility for liver transplantation among referred adults. METHODS: We studied all prospectively followed recipient candidates at a single centre who were deemed unsuitable for liver transplantation after assessment. Inclusion criteria were age 18 years and older and completion of a standard liver transplantation evaluation over a 3-year period. Patients were excluded if they had a history of prior assessment or liver transplantation within the study period. Demographic and baseline clinical data and reasons for recipient ineligibility were recorded. RESULTS: In all, 337 patients underwent their first liver transplantation evaluation during the study period; 166 (49.3%) fulfilled inclusion criteria. The mean age was 55.4 years, and 106 (63.9%) were men. The 3 most common reasons for denial of listing were patient too well (n = 82, 49.4%), medical comorbidities and/or need for medical optimization (n = 43, 25.9%) and need for addiction rehabilitation (n = 28, 16.9%). CONCLUSION: Ineligibility for transplantation after assessment was common, occurring in nearly half of the cohort. Most denied candidates could be identified with more discriminate screening before the resource-intensive assessment; however, the assessment likely provides unforeseen positive impacts on patient care.
Authors: Michael R Charlton; Justin M Burns; Rachel A Pedersen; Kymberly D Watt; Julie K Heimbach; Ross A Dierkhising Journal: Gastroenterology Date: 2011-07-02 Impact factor: 22.682
Authors: Vincenzo Mazzaferro; Josep M Llovet; Rosalba Miceli; Sherrie Bhoori; Marcello Schiavo; Luigi Mariani; Tiziana Camerini; Sasan Roayaie; Myron E Schwartz; Gian Luca Grazi; René Adam; Peter Neuhaus; Mauro Salizzoni; Jordi Bruix; Alejandro Forner; Luciano De Carlis; Umberto Cillo; Andrew K Burroughs; Roberto Troisi; Massimo Rossi; Giorgio E Gerunda; Jan Lerut; Jacques Belghiti; Ilka Boin; Jean Gugenheim; Fedja Rochling; Bart Van Hoek; Pietro Majno Journal: Lancet Oncol Date: 2008-12-04 Impact factor: 41.316
Authors: V Martel-Laferrière; A Michel; S Schaefer; S Bindal; K Bichoupan; A D Branch; S Huprikar; T D Schiano; P V Perumalswami Journal: Transpl Infect Dis Date: 2015-06-15 Impact factor: 2.228
Authors: Gina Choi; Jihane N Benhammou; Jung J Yum; Elena G Saab; Ankur P Patel; Andrew J Baird; Stephanie Aguirre; Douglas G Farmer; Sammy Saab Journal: J Clin Exp Hepatol Date: 2021-09-22