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Regional sharing for adult status 1 candidates: Reduction in waitlist mortality
Author(s) -
Washburn Kenneth,
Harper Ann,
Klintmalm Goran,
Goss John,
Halff Glenn
Publication year - 2006
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20768
Subject(s) - medicine , united network for organ sharing , mortality rate , organ procurement , transplantation , demography , liver transplantation , sociology
Abstract The intent of regional sharing for status 1 candidates is to promote timely access to donor livers. Presumably this decreases waitlist mortality. Little published data exists that supports this policy. Organ Procurement and Transplantation Network data was used to calculate region 4 and national adult waitlist death and transplant rates 4 yr prior to (period A) and after (period B) implementation of the sharing agreement in July 1999. Death and transplant rates were calculated using a competing risk analysis. Regional sharing resulted in a reduction in adult status 1 waitlist death rate and an increase in transplant rate for region 4 candidates at 7 and 14 days ( P > 0.05) without a change in the death rate at 90 days for the non‐status 1 candidates. National data showed a significant increase in transplant rate at 7 days and reduction in waitlist death rate at 14 days after listing ( P < 0.05). Status 1 waiting time was decreased from 10 to 3 days ( P < 0.05). Adult patient survival was not significantly different between the periods. In conclusion, regional sharing for status 1 candidates results in an increased transplant rate and a reduction in waitlist mortality. Sharing did not impact waitlist mortality for non‐status 1 candidates. Liver Transpl 12: 470–474, 2006. © 2006 AASLD.