Living Donor Liver Transplantation for Alcohol-related Liver Disease: An Intention-to-treat Analysis
Rattachement africain : ch, ca, nl, se, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Alcohol-associated liver disease (ALD) is the leading indication for liver transplantation (LT) in the Western world. Although 6 mo of abstinence is no longer a criterion for patients with ALD, the outcomes of living donor LT (LDLT) versus deceased donor LT (DDLT) are not well established. METHODSS: We performed an intention-to-treat analysis to evaluate the impact of listing and pursuing primary LDLT (pLDLT) compared with primary DDLT (pDDLT). The primary endpoint was overall survival from date of listing, evaluated using Cox regression (hazard ratios). RESULTS: Two hundred thirty-three patients with ALD were listed for LT, of which 27 (12%) were pLDLT. The overall median model for end-stage liver disease (MELD) score at listing was 20 and Na-MELD 24, a median abstinence of 4.5 mo, and 128 (55%) underwent transplantation. There was no statistically significant adjusted difference at 3-y overall survival between pLDLT versus pDDLT (adjusted hazard ratio [HR] 0.72; P = 0.550) and in the as-treated analysis (HR 1.22; P = 0.741). No patients were delisted in the pLDLT group, whereas 86 (42%) patients were delisted in the pDDLT group; primarily because of death (46 [50%]) and medical improvement (24 [28%]). Alcohol use since the time of listing was documented in 29 (13%) patients; immortal time bias adjusted analysis found no significant difference between pLDLT and pDDLT (adjusted HR 1.07; P = 0.900) and the as-treated analysis (HR 2.95; P = 0.130). CONCLUSIONS: Patients with ALD benefit from intention pLDLT with lower rates of waitlist dropout and delisting, attributable to mortality or medical deterioration, and should be encouraged to pursue this option.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Living Donor Liver Transplantation for Alcohol-related Liver Disease: An Intention-to-treat Analysis
- Date Crossref
- 24/04/2025
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Bern pays non établi dans la noticeUniversité ou école supérieure
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University Health Network Multi-Organ Transplant Program pays non établi dans la noticeÉtablissement de santé
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University of Toronto Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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University Hospital of Bern pays non établi dans la noticeÉtablissement de santé
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Erasmus MC pays non établi dans la noticeÉtablissement de santé
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Erasmus MC Cancer Institute pays non établi dans la noticeÉtablissement de santé
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Uppsala University Hospital Department of Surgical Sciences pays non établi dans la noticeÉtablissement de santé
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Henry Ford Hospital Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Bern University Hospital Department of Visceral Surgery and Medicine pays non établi dans la noticeUniversité ou école supérieure
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University Medical Center Rotterdam Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
University of Bern, Multi-Organ Transplant Program — University Health Network et Department of Surgery — University of Toronto, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.