{"title":"亚洲人群肝移植可及性和患者生存率:共享前35 vs共享后35","authors":"Yefei Zhang","doi":"10.4172/2375-4273.1000187","DOIUrl":null,"url":null,"abstract":"Background: Studies addressing ethnic disparities and trends in liver transplantation for Asian population are scant. Objective: To examine the impact of Share 35 policy on Asian patients’ access to liver transplantation and outcomes since its implementation in June 2013. Methods: A total of 11,910 adult white and Asian patients who were registered for deceased donor liver transplantation between 2012 and 2015, was identified from the United Network for Organ Sharing database. Logistic regression and proportional hazard models with adjustment for demographic, clinical and geographic factors were used to model the access to liver transplantation and patient survival. Stratification on pre- and post-Share 35 periods was performed to compare the first 18 months of Share 35 policy to an equivalent period. Results: Comparison of the pre- and post-Share 35 periods showed a significant decrease in time on waiting list and higher proportions of patients receiving liver transplantation for Asian patients. Asians shared similar transplant rates as whites (OR: 1.15, 95% CI: 0.80–1.67) but experienced significantly longer waiting time (HR: 0.56, 95% CI: 0.34–0.92) before they received liver transplantation after Share 35 policy took effect. No significant post-transplantation survival difference was observed between Asians and whites at the 18-month outcome. Conclusion: Although benefited from the Share 35 policy, Asian patients are still at greater risk of disparities in access to liver transplantation.","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2017-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"4","resultStr":"{\"title\":\"Access to Liver Transplantation and Patient Survival among Asian Populations: Pre-Share 35 vs Post-Share 35\",\"authors\":\"Yefei Zhang\",\"doi\":\"10.4172/2375-4273.1000187\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Studies addressing ethnic disparities and trends in liver transplantation for Asian population are scant. Objective: To examine the impact of Share 35 policy on Asian patients’ access to liver transplantation and outcomes since its implementation in June 2013. Methods: A total of 11,910 adult white and Asian patients who were registered for deceased donor liver transplantation between 2012 and 2015, was identified from the United Network for Organ Sharing database. Logistic regression and proportional hazard models with adjustment for demographic, clinical and geographic factors were used to model the access to liver transplantation and patient survival. Stratification on pre- and post-Share 35 periods was performed to compare the first 18 months of Share 35 policy to an equivalent period. Results: Comparison of the pre- and post-Share 35 periods showed a significant decrease in time on waiting list and higher proportions of patients receiving liver transplantation for Asian patients. Asians shared similar transplant rates as whites (OR: 1.15, 95% CI: 0.80–1.67) but experienced significantly longer waiting time (HR: 0.56, 95% CI: 0.34–0.92) before they received liver transplantation after Share 35 policy took effect. No significant post-transplantation survival difference was observed between Asians and whites at the 18-month outcome. Conclusion: Although benefited from the Share 35 policy, Asian patients are still at greater risk of disparities in access to liver transplantation.\",\"PeriodicalId\":14242,\"journal\":{\"name\":\"International Journal of Organ Transplantation Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2017-02-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Organ Transplantation Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4172/2375-4273.1000187\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"TRANSPLANTATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Organ Transplantation Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4172/2375-4273.1000187","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"TRANSPLANTATION","Score":null,"Total":0}
Access to Liver Transplantation and Patient Survival among Asian Populations: Pre-Share 35 vs Post-Share 35
Background: Studies addressing ethnic disparities and trends in liver transplantation for Asian population are scant. Objective: To examine the impact of Share 35 policy on Asian patients’ access to liver transplantation and outcomes since its implementation in June 2013. Methods: A total of 11,910 adult white and Asian patients who were registered for deceased donor liver transplantation between 2012 and 2015, was identified from the United Network for Organ Sharing database. Logistic regression and proportional hazard models with adjustment for demographic, clinical and geographic factors were used to model the access to liver transplantation and patient survival. Stratification on pre- and post-Share 35 periods was performed to compare the first 18 months of Share 35 policy to an equivalent period. Results: Comparison of the pre- and post-Share 35 periods showed a significant decrease in time on waiting list and higher proportions of patients receiving liver transplantation for Asian patients. Asians shared similar transplant rates as whites (OR: 1.15, 95% CI: 0.80–1.67) but experienced significantly longer waiting time (HR: 0.56, 95% CI: 0.34–0.92) before they received liver transplantation after Share 35 policy took effect. No significant post-transplantation survival difference was observed between Asians and whites at the 18-month outcome. Conclusion: Although benefited from the Share 35 policy, Asian patients are still at greater risk of disparities in access to liver transplantation.
期刊介绍:
The International Journal of Organ Transplantation Medicine (IJOTM) is a quarterly peer-reviewed English-language journal that publishes high-quality basic sciences and clinical research on transplantation. The scope of the journal includes organ and tissue donation, procurement and preservation; surgical techniques, innovations, and novelties in all aspects of transplantation; genomics and immunobiology; immunosuppressive drugs and pharmacology relevant to transplantation; graft survival and prevention of graft dysfunction and failure; clinical trials and population analyses in the field of transplantation; transplant complications; cell and tissue transplantation; infection; post-transplant malignancies; sociological and ethical issues and xenotransplantation.