ArticleThe Lancet regional health. Western Pacific2021
Impact of COVID-19 on Liver Transplantation in Hong Kong and Singapore: A Modelling Study.
Article in The Lancet regional health. Western Pacific, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Effect of coronavirus disease 2019 on diagnosis and treatment of hepatocellular carcinoma: a systematic review.Exploration of targeted anti-tumor therapy · 2023Pooled it
- [Proportion and clinical characteristics of probable metabolic-associated fatty liver disease-related cirrhosis in cryptogenic cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- Status of hepatitis B virus and hepatitis C elimination in Singapore: a call for action.Singapore medical journal · 2025Article
- GraftIQ: Hybrid multi-class neural network integrating clinical insight for multi-outcome prediction in liver transplant recipients.Nature communications · 2025Article
- Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions.Nature reviews. Gastroenterology & hepatology · 2024Review
- Scoping review of modelling studies assessing the impact of disruptions to essential health services during COVID-19.BMJ open · 2023Article
- Global epidemiology of cirrhosis - aetiology, trends and predictions.Nature reviews. Gastroenterology & hepatology · 2023Review
- Global epidemiology of alcohol-associated cirrhosis and HCC: trends, projections and risk factors.Nature reviews. Gastroenterology & hepatology · 2023Review
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLiver transplantation (LT) activities during the COVID-19 pandemic have been curtailed in many countries. The impact of various policies restricting LT on outcomes of potential LT candidates is unclear.
methodsWe studied all patients on the nationwide LT waitlists in Hong Kong and Singapore between January 2016 and May 2020. We used continuous time Markov chains to model the effects of different scenarios and varying durations of disruption on LT candidates.
findingsWith complete cessation of LT, the projected 1-year overall survival (OS) decreased by 3•6%, 10•51% and 19•21% for a 1-, 3- and 6-month disruption respectively versus no limitation to LT, while 2-year OS decreased by 4•1%, 12•55%, and 23•43% respectively. When only urgent (acute-on-chronic liver failure [ACLF] or acute liver failure) LT was allowed, the projected 1-year OS decreased by a similar proportion: 3•1%, 8•41% and 15•20% respectively. When deceased donor LT (DDLT) and urgent living donor LT (LDLT) were allowed, 1-year projected OS decreased by 1•2%, 5•1% and 8•85% for a 1-, 3- and 6-month disruption respectively. OS was similar when only DDLT was allowed. Complete cessation of LT activities for 3-months resulted in an increased projected incidence of ACLF and hepatocellular carcinoma (HCC) dropout at 1-year by 49•1% and 107•96% respectively. When only urgent LT was allowed, HCC dropout and ACLF incidence were comparable to the rates seen in the scenario of complete LT cessation.
interpretationA short and wide-ranging disruption to LT results in better outcomes compared with a longer duration of partial restrictions.
fundingNone to disclose.
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