Evidence map›Paper›PMID 39359941›Full record

ArticleTransplantation direct2024

Beyond 75: Graft Allocation and Organ Utility Implications in Liver Transplantation.

Miho Akabane, Allison Kwong, Yuki Imaoka, Carlos O Esquivel, W Ray Kim, Marc L Melcher, Kazunari Sasaki

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Transplantation direct, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

7 authors.

Miho AkabaneDivision of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA.ORCID https://orcid.org/0000-0002-6705-5730
Allison KwongDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA.
Yuki ImaokaDivision of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA.
Carlos O EsquivelDivision of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA.
W Ray KimDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA.
Marc L MelcherDivision of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA.
Kazunari SasakiDivision of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA.ORCID https://orcid.org/0000-0003-2514-5778

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The global surge in aging has intensified debates on liver transplantation (LT) for candidates aged 75 y and older, given the prevalent donor scarcity. This study examined both the survival benefits and organ utility of LT for this age group. Methods: A total of 178 469 adult LT candidates from the United Network for Organ Sharing database (2003-2022) were analyzed, with 112 266 undergoing LT. Post-LT survival outcomes and waitlist dropout rates were monitored across varying age brackets. Multivariable Cox regression analysis determined prognostic indicators. The 5-y survival benefit was assessed by comparing LT recipients to waitlist candidates using hazard ratios. Organ utility was evaluated through a simulation model across various donor classifications. Results: Among candidates aged 75 y and older, 343 received LT. The 90-d graft and patient survival rates for these patients were comparable with those in other age categories; however, differences emerged at 1 and 3 y. Age of 75 y or older was identified as a significant negative prognostic indicator for 3-y graft survival (hazard ratio: 1.72 [1.20-2.42], Conclusions: Although LT offers survival benefits to individuals aged 75 y and older, the system may need rethinking to optimize the use of scarce donor livers, perhaps by matching older donors with older recipients.

Identifiers

PMID39359941
PMCPMC11446594

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Registered trials

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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.