ArticleJournal of hepatology2016
Liver transplant center variability in accepting organ offers and its impact on patient survival.
Article in Journal of hepatology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed.
- Process Variation in Liver, Kidney, and Pancreas Transplantation: A Multicenter Evaluation From the Consortium for the Holistic Assessment of Risk in Transplant.Transplantation direct · 2025Article
- Referral to Liver Transplant: A National Survey from Portugal.GE Portuguese journal of gastroenterology · 2025Article
- Donor sequence number is not associated with worse lung transplant outcomes regardless of transplant center case volume.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2025Article
- Outcomes for Patients With a Deceased Donor Kidney Offer in the New Allocation System.Kidney international reports · 2025Article
- Lost in Transplantation: Characterizing Racial Gaps in Physician Organ Offer Acceptance.medRxiv : the preprint server for health sciences · 2024Article
- Center expansion of liver transplants using donation after circulatory death organs is associated with reduced overall waitlist mortality.Clinical transplantation · 2023Article
- The evolution of the liver transplant candidate.Frontiers in transplantation · 2023Review
- Center variations in patient selection for simultaneous heart-kidney transplantation.Clinical transplantation · 2022Article
- Risk Aversion, Organ Utilization and Changing Behavior.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- The Suitability of Potential Organ Donors Using Real Case-Scenarios; Do we Need to Create a "Donor Board" Process for Donors Perceived as Unlikely Suitable?Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- Reexamining Risk Aversion: Willingness to Pursue and Utilize Nonideal Donor Livers Among US Donation Service Areas.Transplantation direct · 2021Article
- Center variation in long-term outcomes for socioeconomically deprived children.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Viability Assessment in Liver Transplantation-What Is the Impact of Dynamic Organ Preservation?Biomedicines · 2021Review
- RELATIONSHIP BETWEEN DONOR QUALITY AND RECIPIENT GRAVITY IN LIVER TRANSPLANT.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2020Article
- Quantifying Sex-Based Disparities in Liver Allocation.JAMA surgery · 2020Article
- Transplant Center Variability in Organ Offer Acceptance and Mortality Among US Patients on the Heart Transplant Waitlist.JAMA cardiology · 2020Article
- Variability in donor organ offer acceptance and lung transplantation survival.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2020Article
- Tool to Aid Patients in Selecting a Liver Transplant Center.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2020Article
- Geographic Disparity in Deceased Donor Liver Transplant Rates Following Share 35.Transplantation · 2019Article
- Geographic disparities in liver supply/demand ratio within fixed-distance and fixed-population circles.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Article
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Authors and funding
8 authors.
Funding
Abstract
BACKGROUND &
aimsDespite an allocation system designed to give deceased-donor livers to the sickest patients, many transplantable livers are declined by U.S. transplant centers. It is unknown whether centers vary in their propensities to decline organs for the highest priority patients, and how these decisions directly impact patient outcomes.
methodsWe analyzed Organ Procurement and Transplantation Network (OPTN) data from 5/1/07-6/17/13, and included all adult liver-alone waitlist candidates offered an organ that was ultimately transplanted. We evaluated acceptance rates of liver offers for the highest ranked patients and their subsequent waitlist mortality.
resultsOf the 23,740 unique organ offers, 8882 (37.4%) were accepted for the first-ranked patient. Despite adjusting for organ quality and recipient severity of illness, transplant centers within and across geographic regions varied strikingly (p<0.001) in the percentage of organ offers they accepted for the highest priority patients. Among all patients ranked first on waitlists, the adjusted center-specific organ acceptance rates ranged from 15.7% to 58.1%. In multivariable models, there was a 27% increased odds of waitlist mortality for every 5% absolute decrease in a center's adjusted organ offer acceptance rate (adjusted OR: 1.27, 95% CI: 1.20-1.32). However, the absolute difference in median 5-year adjusted graft survival was 4% between livers accepted for the first-ranked patient, compared to those declined and transplanted at a lower position.
conclusionThere is marked variability in center practices regarding accepting livers allocated to the highest priority patients. Center-level decisions to decline organs substantially increased patients' odds of dying on the waitlist without a transplant.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.