Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective
<b>Background:</b> The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the tim...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/11/11/1173 |
| _version_ | 1797509723112603648 |
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| author | Hui-Ying Lin Cheng-Maw Ho Pei-Yin Hsieh Min-Heuy Lin Yao-Ming Wu Ming-Chih Ho Po-Huang Lee Rey-Heng Hu |
| author_facet | Hui-Ying Lin Cheng-Maw Ho Pei-Yin Hsieh Min-Heuy Lin Yao-Ming Wu Ming-Chih Ho Po-Huang Lee Rey-Heng Hu |
| author_sort | Hui-Ying Lin |
| collection | DOAJ |
| description | <b>Background:</b> The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. <b>Methods:</b> In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. <b>Results:</b> From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0–58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0–188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient’s critical illness, donor’s physical conditions, motivation for live donation, and stable condition while on the waiting list. <b>Conclusions:</b> Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process. |
| first_indexed | 2024-03-10T05:21:49Z |
| format | Article |
| id | doaj.art-7edb1730683848948fd704c8b9d0b432 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T05:21:49Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-7edb1730683848948fd704c8b9d0b4322023-11-22T23:59:00ZengMDPI AGJournal of Personalized Medicine2075-44262021-11-011111117310.3390/jpm11111173Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s PerspectiveHui-Ying Lin0Cheng-Maw Ho1Pei-Yin Hsieh2Min-Heuy Lin3Yao-Ming Wu4Ming-Chih Ho5Po-Huang Lee6Rey-Heng Hu7Department of Nursing, National Taiwan University Hospital and College of Medicine, Taipei 100, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, Taipei 100, TaiwanDepartment of Nursing, National Taiwan University Hospital and College of Medicine, Taipei 100, TaiwanDepartment of Nursing, National Taiwan University Hospital and College of Medicine, Taipei 100, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, Taipei 100, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, Taipei 100, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, Taipei 100, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, Taipei 100, Taiwan<b>Background:</b> The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. <b>Methods:</b> In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. <b>Results:</b> From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0–58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0–188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient’s critical illness, donor’s physical conditions, motivation for live donation, and stable condition while on the waiting list. <b>Conclusions:</b> Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process.https://www.mdpi.com/2075-4426/11/11/1173live donor liver transplantationintend to donateroot causerisk factor |
| spellingShingle | Hui-Ying Lin Cheng-Maw Ho Pei-Yin Hsieh Min-Heuy Lin Yao-Ming Wu Ming-Chih Ho Po-Huang Lee Rey-Heng Hu Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective Journal of Personalized Medicine live donor liver transplantation intend to donate root cause risk factor |
| title | Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective |
| title_full | Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective |
| title_fullStr | Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective |
| title_full_unstemmed | Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective |
| title_short | Circuitous Path to Live Donor Liver Transplantation from the Coordinator’s Perspective |
| title_sort | circuitous path to live donor liver transplantation from the coordinator s perspective |
| topic | live donor liver transplantation intend to donate root cause risk factor |
| url | https://www.mdpi.com/2075-4426/11/11/1173 |
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