Liver Transplantation最新文献_第10页

Racial and ethnic disparities in liver transplant access vary within and across transplant referral regions. 肝移植可及性的种族和民族差异在移植转诊地区内部和不同地区有所不同。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-14 DOI: 10.1097/LVT.0000000000000561

Arrey-Takor Ayuk-Arrey, Lauren Nephew, Juan Carlos Caicedo, Katherine Ross-Driscoll

{"title":"Racial and ethnic disparities in liver transplant access vary within and across transplant referral regions.","authors":"Arrey-Takor Ayuk-Arrey, Lauren Nephew, Juan Carlos Caicedo, Katherine Ross-Driscoll","doi":"10.1097/LVT.0000000000000561","DOIUrl":"10.1097/LVT.0000000000000561","url":null,"abstract":"Prior studies have demonstrated racial disparities in access to liver transplantation, but the determinants of these disparities remain poorly understood. We used geographic catchment areas for transplant centers (transplant referral regions, TRRs) to characterize transplant environment contributors to racial and ethnic disparities in liver transplant access. Data were obtained from the Scientific Registry for Transplant Recipients and the National Center for Health Statistics from 2015 to 2021. The primary outcome was the difference in the listing-to-end-stage liver disease death ratio between Black, Hispanic, and non-Hispanic White patients for each TRR. We accounted for demographics, socioeconomic status, health care access, organ availability, and transplant center competition using multivariable linear regression. We examined intra-TRR differences in waitlist composition using Levene's test of variance. Across the 66 included TRRs, Black patients had lower listing-to-end-stage liver disease death ratios than White patients in 80% of TRRs, while Hispanic patients had equal or higher listing-to-end-stage liver disease death ratios compared to White patients in 56% of TRRs. The majority of variation in racial disparities across TRRs remained unexplained by multivariable models. Disparities were attenuated after excluding patients with HCC-associated mortality. Among the 27 TRRs that contained more than one transplant center, variance across TRRs was statistically significant for Black and Hispanic waitlist composition. We observed substantial geographic variation in the magnitude of racial disparities in liver transplant access across the United States. Findings highlight the need for targeted health equity interventions in regions with high disparities and the development of disparity-sensitive access metrics for transplant centers.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Liver transplantation after ex vivo normothermic machine preservation without recooling the graft: A clinical series from a single center. 无再冷却的离体恒温机器保存后的肝移植：来自单一中心的临床系列。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-13 DOI: 10.1097/LVT.0000000000000564

Salvatore Gruttadauria, Ivan Vella, Sergio Li Petri, Caterina Accardo, Pasquale Bonsignore, Alessandro Tropea, Sergio Calamia, Duilio Pagano, Gaetano Burgio, Rosalia Longo, Fabrizio di Francesco

引用次数: 0

Noninvasive assessment of renal dysfunction in patients with end-stage liver disease: New solutions for old problems? 终末期肝病患者肾功能的无创评估：老问题的新解决方案？

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-13 DOI: 10.1097/LVT.0000000000000566

Simone Incicco, Carmine Gambino

引用次数: 0

Preoperative assessment of body composition and sarcopenia in candidates for multivisceral transplant . 多脏器移植候选者的体成分和肌肉减少症的术前评估。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-13 DOI: 10.1097/LVT.0000000000000565

Ruy J Cruz, Hao Liu, Ajai Khanna, Colin Powers, Vikraman Gunabushanam, Andrea DiMartini

引用次数: 0

Letter to the Editor: Impact of long-term continuous terlipressin infusion on the liver transplant waitlist in an Australian cohort. 致编辑的信：澳大利亚队列中长期持续输注特利加压素对肝移植等待名单的影响。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-01 Epub Date: 2024-08-15 DOI: 10.1097/LVT.0000000000000456

Marie Sinclair, Brooke Chapman, Avik Majumdar, Adam Testro

引用次数: 0

Introducing the History, Culture, and Liver Disease series. 历史、文化和肝病系列介绍。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-01 Epub Date: 2024-08-26 DOI: 10.1097/LVT.0000000000000472

Russell Rosenblatt

引用次数: 0

Mapping out a Medication Adherence Promotion System (MAPS): Can it reduce graft rejection in pediatric liver transplantation? 绘制药物依从性促进系统 (MAPS)：它能减少小儿肝移植中的移植物排斥反应吗？

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-01 Epub Date: 2024-09-02 DOI: 10.1097/LVT.0000000000000479

Sarah R Lieber, Marina Serper

引用次数: 0

Cystatin C in decompensated cirrhosis: Shedding the excess baggage in clinical practice. 失代偿期肝硬化中的胱抑素 C：在临床实践中甩掉多余的包袱。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-01 Epub Date: 2024-10-22 DOI: 10.1097/LVT.0000000000000516

Erin F Barreto, Olivia C Walker, Sumeet K Asrani

引用次数: 0

Transjugular intrahepatic portosystemic shunt for the patients on the liver transplant list. 经颈静脉肝内门静脉分流术在肝移植名单上的应用。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-01 Epub Date: 2024-09-09 DOI: 10.1097/LVT.0000000000000429

Cristina Ripoll, Falk Rauchfuss, Rene Aschenbach, Utz Settmacher, Alexander Zipprich

引用次数: 0

Cystatin C and the difference between cystatin C and serum creatinine: Improved metrics to predict waitlist mortality among patients with decompensated cirrhosis. 胱抑素 C 以及胱抑素 C 与血清肌酐之间的差异：预测失代偿期肝硬化患者候诊死亡率的改进指标。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-01 Epub Date: 2024-07-24 DOI: 10.1097/LVT.0000000000000439

Giuseppe Cullaro, Andrew S Allegretti, Kavish R Patidar, Elizabeth C Verna, Jennifer C Lai

{"title":"Cystatin C and the difference between cystatin C and serum creatinine: Improved metrics to predict waitlist mortality among patients with decompensated cirrhosis.","authors":"Giuseppe Cullaro, Andrew S Allegretti, Kavish R Patidar, Elizabeth C Verna, Jennifer C Lai","doi":"10.1097/LVT.0000000000000439","DOIUrl":"10.1097/LVT.0000000000000439","url":null,"abstract":"Among patients with decompensated cirrhosis, serum creatinine (sCr) is biased by sex, frailty, and hepatic synthetic function, while Cystatin C (cysC) is not. We found that sCr would better associate with waitlist mortality and that the difference between cysC and sCr (cysCsCr diff ) would quantify this bias and be independently associated with outcomes. We measured cysC levels at ambulatory liver transplant visits among 525 consecutive patients seen at our center. We defined the cysCsCr diff as the difference between cysC minus sCr. We compared demographics and clinical characteristics in patients with low, intermediate, and high cysCsCr diff , divided by tertile. We used Cox regression to compare the association between sCr and cysC and waitlist mortality and demonstrate the independent association between cysCsCr diff and waitlist mortality. In Cox regression, cysC was significantly more associated with waitlist mortality than sCr ( p < 0.001). We found that as compared to those with a low cysCsCr diff , those with an intermediate or high cysCsCr diff were more likely to be female, have ascites, have higher frailty, and have higher MELD 3.0 scores ( p < 0.05 for all). Compared to those with a low cysCsCr diff , we found that those in the intermediate and high groups were more likely to die during follow-up (low: 6% vs. intermediate: 8% vs. high: 11%, p = 0.007). We found that after adjusting for the components of the MELD 3.0 score, each 1-point increase in the cysCsCr diff was associated with 1.72× (1.27-2.32) the hazard of waitlist mortality. Our study demonstrates that not only is cysC more associated with waitlist mortality than sCr, but that cysCsCr diff represents a novel independent metric associated with waitlist mortality.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"24-31"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0