Evidence map›Paper›PMID 36582673›Full record

ArticleTransplantation direct2023

Perceptions and Early Outcomes of the Acuity Circles Allocation Policy Among Liver Transplant Centers in the United States.

Natalie Pawlak, Cherilyn Song, Saba Alvi, Kimberly Schuster, Nicole Segalini, Yong K Kwon, Mohamed E Akoad, M Ameen Rauf, David Mulligan, Hassan Aziz

Open access · goldAbstract read
In one paragraph

Article in Transplantation direct, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.4field-weighted citation impact, top 11% 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

4 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Impact of acuity circles policy on ABO blood type-related waitlist outcomes in liver transplantation.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026
    Article
  3. Article
  4. Article
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

10 authors at 2 institutions in 1 country.

Natalie PawlakDivision of Transplant and Hepatobiliary Surgery, Tufts University School of Medicine, Boston, MA.
Cherilyn SongDivision of Transplant and Hepatobiliary Surgery, Tufts University School of Medicine, Boston, MA.
Saba AlviDivision of Transplant and Hepatobiliary Surgery, Tufts University School of Medicine, Boston, MA.
Kimberly SchusterDivision of Transplant and Hepatobiliary Surgery, Tufts University School of Medicine, Boston, MA.
Nicole SegaliniDivision of Transplant and Hepatobiliary Surgery, Tufts University School of Medicine, Boston, MA.
Yong K KwonDivision of Transplant and Hepatobiliary Surgery, University of Southern California, Keck School of Medicine, Los Angeles, CA.
Mohamed E AkoadDivision of Transplant and Hepatobiliary Surgery, The Lahey Hospital and Medical Center, Boston, MA.
M Ameen RaufDivision of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, TN.
David MulliganDivision of Transplantation Surgery and Immunology, Yale School of Medicine, New Haven, CT.
Hassan AzizDivision of Transplant and Hepatobiliary Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA.
University of Iowa Hospitals and Clinics · USVanderbilt University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recently, a new liver allocation policy called the acuity circles (AC) framework was implemented to decrease geographic disparities in transplant metrics across donor service areas. Early analyses have examined the changes in outcomes because of the AC policy. However, perceptions among transplant surgeons and staff regarding the new policy remain unknown. Methods: A 28-item survey was sent to division chiefs and surgical directors of liver transplantation across the United States. Questions assessed the respondents' perceptions regarding center-level metrics and staff satisfaction. We used Organ Procurement and Transplantation Network data to study differences in allocation between the pre-AC implementation period (2019) and the post-AC implementation period (2020-2021). Results: A total of 40 participants completed this ongoing survey study. Most responses were from region 8 (13%), region 10 (15%), and region 11 (13%). Sixty-three percent of respondents stated that the wait time for a suitable offer for recipients with model of end-stage liver disease score <30 has decreased, whereas 50% stated that wait time for a suitable offer for recipients with model of end-stage liver disease score >30 has increased. However, most respondents (75%) felt that the average cost per transplant had increased and that the rate of surgical complications and 1-y graft survival had remained the same. In most states, an observable decrease in in-state liver transplantations occurred each year between 2019 and 2021. In addition, most allocation regions reported an increase in donations after circulatory deaths between 2019 and 2021. Conclusions: Perceptions of the new AC policy among liver transplant surgeons in the United States remain mixed, highlighting the potential strengths and concerns regarding its future impact. Further studies should assess the effects of the AC policy on clinical outcomes and liver transplantation access.

Identifiers

PMID36582673
PMCPMC9750633
OpenAlexW4312185600

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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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.