Liver Transplantation
Conditions
Keywords
Liver transplantation, Allocation process, Extended-criteria donors, Survival
Brief summary
A major limitation of liver transplantation is organ shortage. To avoid exposing patients to death on the waiting list, organs are used that would have been discarded few years ago. Graft allocation is regulated by the agence de biomedecine which establishes a national score. Each liver graft is proposed to the patient presenting the higher score. Acceptance or rejection of the graft only depends on the decision of each centre. We propose to submit a more efficient allocation model (enabling each proposed liver graft to be transplanted in the candidate whose transplantation will afford the greatest survival benefit after registration), by collecting and analysing variables from donors and candidates/recipients.
Interventions
None listed
Sponsors
Agence de La Biomédecine
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Liver transplant candidates : All adult LT candidates listed on the French wait list between 2009 and 2014 and followed prospectively by the mean yearly follow-up under the control of ABM. * Donors : all adults donors registered over the same 2009-2014 period, including donors whose livers were procured and transplanted, whose liver were procured and discarded, and donors in whom liver was not harvested.
Exclusion criteria
* Pediatric recipients * Pediatric donors
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Survival analysis | 5 years | In view of the complexity of our project, different parallel approaches will be performed in order to establish predictive models |
| Multi-state models | 5 years | In view of the complexity of our project, different parallel approaches will be performed in order to establish predictive models |
| Decision tree analysis | 5 years | In view of the complexity of our project, different parallel approaches will be performed in order to establish predictive models |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of each criterion of ECD (Donor population) | 5 years | — |
| Donor scores (DRI, ELTR) (Donor population) | 5 years | — |
| mean score (Donor population) | 5 years | — |
| mean age of donors (Donor population) | 5 years | — |
| graft failure (Donor population) | 5 years | — |
| grafts with correct primary function (Donor population) | 5 years | — |
| epidemiological characteristics (Candidate population) | 5 years | — |
| indication for transplantation (Candidate population) | 5 years | — |
| number of ECD criteria (Donor population) | 5 years | — |
| comorbidities (Candidate population) | 5 years | — |
| time on waiting list (Candidate population) | 5 years | — |
| Proportion of early deaths after transplantation (Candidate population) | 5 years | — |
| drop-outs for worsening (Candidate population) | 5 years | Description of events occurring on waiting list |
| deaths on the waiting list (Candidate population) | 5 years | — |
| median time of occurrence (Candidate population) | 5 years | Description of events occurring on waiting list |
| number of drop-outs for improvement (Candidate population) | 5 years | — |
| percentages of drop-outs for improvement (Candidate population) | 5 years | — |
| severity of disease (Candidate population) | 5 years | — |
| frequency of ECD criteria (Donor population) | 5 years | — |
| Number of each criterion of ECD (Donor population) | 5 years | — |
Outcome results
None listed