ArticleHepatology (Baltimore, Md.)2018
Improved posttransplant mortality after share 35 for liver transplantation.
Article in Hepatology (Baltimore, Md.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04530240 (Impact of National MELD ≥ 30 Priority Allocation System on Dropout and Post-Transplant Survival Rates in Italy), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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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.
Impact of National MELD ≥ 30 Priority Allocation System on Dropout and Post-Transplant Survival Rates in Italy: A Retrospective Competing-Risk Analysis
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mitochondrial Consequences of Organ Preservation Techniques during Liver Transplantation.International journal of molecular sciences · 2021Pooled it
- US Population Size and Outcomes of Adults on Liver Transplant Waiting Lists.JAMA network open · 2025Article
- Review
- MELD-GRAIL and MELD-GRAIL-Na Are Not Superior to MELD or MELD-Na in Predicting Liver Transplant Waiting List Mortality at a Single-center Level.Transplantation direct · 2022Article
- The Role of von Willebrand Factor Antigen in Predicting Survival of Patients with HBV-Related Cirrhosis.Canadian journal of gastroenterology & hepatology · 2022Article
- Development of a Novel Prognostic Nomogram for High Model for End-Stage Liver Disease Score Recipients Following Deceased Donor Liver Transplantation.Frontiers in medicine · 2022Article
- Impact of the Share 35 Policy on Perioperative Management and Mortality in Liver Transplantation Recipients.Annals of transplantation · 2021Article
- The Addition of C-Reactive Protein and von Willebrand Factor to Model for End-Stage Liver Disease-Sodium Improves Prediction of Waitlist Mortality.Hepatology (Baltimore, Md.) · 2021Article
- Mitochondrial Targeting Therapy Role in Liver Transplant Preservation Lines: Mechanism and Therapeutic Strategies.Cureus · 2021Review
- The von Willebrand Factor Facilitates Model for End-Stage Liver Disease-Independent Risk Stratification on the Waiting List for Liver Transplantation.Hepatology (Baltimore, Md.) · 2020Article
- Women who undergo liver transplant have longer length of stay post-transplant compared with men.Liver international : official journal of the International Association for the Study of the Liver · 2020Article
- Approaches for patients with very high MELD scores.JHEP reports : innovation in hepatology · 2019Review
- Article
- Liver transplantation for critically ill cirrhotic patients: Overview and pragmatic proposals.World journal of gastroenterology · 2018Review
- Trends of characteristics and outcomes of donors and recipients of deceased donor liver transplantation in the United States: 1990 to 2013.World journal of transplantation · 2018Article
- HEP-Net opinion on the management of ascites and its complications in the setting of decompensated cirrhosis in the resource constrained environment of Pakistan.Pakistan journal of medical sciencesArticle
- Outcomes of liver transplant recipients with high MELD scores: an experience from a Canadian centre.Canadian journal of surgery. Journal canadien de chirurgieArticle
- Lower Likelihood of Post-transplant Graft Failure, Death, and Retransplantation in the Era of Direct-Acting Antivirals.Journal of clinical and experimental hepatologyArticle
- Liver Transplantation: Protocol for Recipient Selection, Evaluation, and Assessment.Journal of clinical and experimental hepatologyReview
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4 authors.
Funding
Abstract
The Share 35 policy was implemented in June 2013 to improve equity in access to liver transplantation (LT) between patients with fulminant liver failure and those with cirrhosis and severe hepatic decompensation. The aim of this study was to assess post-LT outcomes after Share 35. Relevant donor, procurement, and recipient data were extracted from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database. All adult deceased donor LTs from January 1, 2010, to March 31, 2016, were included in the analysis. One-year patient survival before and after Share 35 was assessed by multivariable Cox proportional hazards analysis, with adjustment for variables known to affect graft survival. Of 34,975 adult LT recipients, 16,472 (47.1%) were transplanted after the implementation of Share 35, of whom 4,599 (27.9%) had a Model for End-Stage Liver Disease (MELD) score ≥35. One-year patient survival improved from 83.9% to 88.4% after Share 35 (P < 0.01) for patients with MELD ≥35. There was no significant impact on survival of patients with MELD <35 (P = 0.69). Quality of donor organs, as measured by a donor risk index without the regional share component, improved for patients with MELD ≥35 (P < 0.01) and worsened for patients with lower MELD (P < 0.01). In multivariable Cox regression analysis, Share 35 was associated with improved 1-year patient survival (hazard ratio, 0.69; 95% confidence interval, 0.60-0.80) in recipients with MELD ≥35.
conclusionShare 35 has had a positive impact on survival after transplantation in patients with MELD ≥35, without a reciprocal detriment in patients with lower acuity; this was in part a result of more favorable donor-recipient matching. (Hepatology 2018;67:273-281).
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