Evidence map›Paper›PMID 28657945›Full record

ArticleAnnals of surgery2017

Expanding the Margins: High Volume Utilization of Marginal Liver Grafts Among >2000 Liver Transplants at a Single Institution.

Karim J Halazun, Ralph C Quillin, Russel Rosenblatt, Advaith Bongu, Adam D Griesemer, Tomoaki Kato, Craig Smith, Fabrizio Michelassi, James V Guarrera, Benjamin Samstein and 2 more

Abstract read
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In one paragraph

Article in Annals of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  16. Bioengineering Liver Transplantation.Bioengineering (Basel, Switzerland) · 2019
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  17. Survival benefit of accepting livers from deceased donors over 70 years old.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Karim J Halazun*Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Weill Cornell School of Medicine, New York, NY †Center for Liver Disease and Transplantation, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY ‡Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medical College, New York, NY.
Ralph C Quillin
Russel Rosenblatt
Advaith Bongu
Adam D Griesemer
Tomoaki Kato
Craig Smith
Fabrizio Michelassi
James V Guarrera
Benjamin Samstein
Robert S Brown
Jean C Emond

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMarginal livers (ML) have been used to expand the donor pool. National utilization of MLs is variable, and in some centers, they are never used. We examined the outcomes of MLs in the largest single center series of MLs used to date and compared outcomes to standard (SL) and living donor (LD) livers.

methodsAnalysis of a prospectively maintained database of all liver transplants performed at our institution from 1998 to 2016. ML grafts were defined as livers from donors >70, livers discarded regionally and shared nationally, livers with cold ischemic time >12 hours, livers from hepatitis C virus positive donors, livers from donation after cardiac death donors, livers with >30% steatosis, and livers split between 2 recipients.

resultsA total of 2050 liver transplant recipients were studied, of these 960 (46.8%) received ML grafts. ML recipients were more likely to have lower MELDs and have hepatocellular carcinoma. Most MLs used were from organs turned down regionally and shared nationally (69%) or donors >70 (22%). Survival of patients receiving MLs did not significantly differ from patients receiving SL grafts (P = 0.08). ML and SL recipients had worse survival than LDs (P < 0.01). Despite nearly half of our recipients receiving MLs, overall survival was significantly better than national survival over the same time period (P = 0.04). Waitlist mortality was significantly lower in our series compared with national results (19% vs 24.0%, P < 0.0001).

conclusionsOutcomes of recipients of ML grafts are comparable to SL transplants. Despite liberal use of these grafts, we have been able to successfully reduce waitlist mortality while exceeding national post-transplant survival metrics.

Indexed as

Living DonorsAdolescentAdultAgedChildDonor SelectionFemaleGraft SurvivalHumansKaplan-Meier EstimateLiver TransplantationMaleMiddle AgedNew YorkOutcome Assessment, Health CarePractice Patterns, Physicians'

Identifiers

PMID28657945

What OpenQuestion holds

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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.