Evidence map›Paper›PMID 34772623›Full record

ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2022

A decline in functional status while awaiting liver transplantation is predictive of increased post-transplantation mortality.

Dmitri Bezinover, Nathaniel R Geyer, Jessica Dahmus, Vernon M Chinchilli, Jonathan G Stine

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 35% of its field
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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Frailty in liver transplantation: Exploring prescribing exercise as medicine to improve patient outcomes.Liver international : official journal of the International Association for the Study of the Liver · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Dmitri BezinoverDivision of Transplant Anesthesia, Department of Anesthesia and Perioperative Medicine, 500 University Drive, Hershey, PA, 17033, USA; Liver Center, The Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
Nathaniel R GeyerDepartment of Public Health Sciences, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
Jessica DahmusDivision of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
Vernon M ChinchilliDepartment of Public Health Sciences, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
Jonathan G StineLiver Center, The Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA, 17033, USA; Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA; Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA. Electronic address: jstine@pennstatehealth.psu.edu.
Pennsylvania State University · USHershey (United States) · US

Funding

NIDDK NIH HHS L30 DK118601
6 · The paper itself

Abstract

backgroundFunctional status (FS) is dynamic and changes over time. We examined how changes in FS while awaiting liver transplantation influence post-transplant outcomes.

methodsData on adult liver transplants performed in the United States during the MELD era were obtained through September 2020. Patient and graft survival were compared between groups with no change or improved FS, and those with worsening FS.

resultsOf the 90,210 transplant recipients included in the analysis, 39,193 (43%) had worsening FS, which was associated with longer waiting-list time (187 vs. 329 days, p < 0.001) and worse patient survival after liver transplant (1858 vs. 1727 days, p < 0.001). A consistent and dose-dependent relationship was observed for each 10-point decrease in Karnofsky Performance Score and post-transplant survival. Multivariable regression analysis confirmed that a decline in FS was associated with worse patient survival (HR 1.15, p < 0.001). Similar findings were observed for graft survival.

conclusionA decline in FS on the waiting-list is associated with significantly greater post-liver transplant mortality in recipients. These results should be taken into consideration when allocating organs and determining transplant candidacy. Strategies to optimize FS prior to transplantation should be prioritized as even subtle decreases in FS are associated with inferior post-transplantation outcomes.

Indexed as

Liver TransplantationAdultFunctional StatusGraft SurvivalHumansRetrospective StudiesUnited StatesWaiting Lists

Identifiers

PMID34772623
PMCPMC10691403
OpenAlexW3210205520

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.