eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
Current issue Archive Manuscripts accepted About the journal Editorial board Subscription Contact Instructions for authors Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
Editorial Policies
Sarajevo Declaration on Integrity and Visibility of Scholarly Publications
4/2020
vol. 6
 
Share:
Send email
Share:
abstract:
Original paper

Impact of liver-directed therapy and non-therapy on the waiting time list of patient candidates for liver transplantation: retrospective survival analysis

Maria del Pilar Bayona Molano
1
,
Lorena Garza
2
,
Genaro Selvaggi
2
,
Jay Vasani
2
,
Juan Carlos Barrera Gutierrez
3
,
Jason Salsamendi
2
,
Shivank Bhatia
2
,
Leopoldo Arosemena
2

  1. Mallinckrodt Institute, Barnes Jewish Hospital, St. Louis, USA
  2. University of Miami Miller School of Medicine, Miami, USA
  3. Kent State University, College of Public Health, Kent, USA
Clin Exp HEPATOL 2020; 6, 4: 304–312
DOI: https://doi.org/10.5114/ceh.2020.102175
Online publish date: 2020/12/30
View full text Get citation
 
PlumX metrics:
Aim of the study
To determine whether liver-directed therapies (LDT) and no therapy affect waiting list times for liver transplant candidates from a single center.

Material and methods
This retrospective study included patients > 12 years of age diagnosed with hepatocellular carcinoma between January 2014 and June 2019 and followed until the date of transplant, date of delisting, loss to follow-up, or date of death. Waiting list time and associated factors were analyzed using Kaplan-Meier and Cox proportional-hazards methods.

Results
A total of 181 patients met the selection criteria. The mean age was 60 years with standard deviation (SD) of 7.8 years. Sixty-six percent underwent transplant, and 64% were classified within the Milan criteria. Men had a lower median waiting list time than women (191 days vs. 236 days, p = 0.0093). The overall median survival time or time to transplant for 50% of the population was 218 days (95% CI: 195-235). Men displayed a 3.1-fold (95% CI: 1.5-6.2) higher probability of transplantation than women (p = 0.002). Patients who received no therapy had a 5-fold higher probability of undergoing transplantation than patients under arterial LDT (HR [95% CI]: 5 [1.2, 20], p = 0.02). Patients under combined LDT displayed a 70% reduced probability of transplantation compared to patients who received arterial LDTs (p = 0.0009).

Conclusions
LDT was associated with a prolonged stay on the transplant list, likely due to the presence of an aggressive liver tumor. However, LDTs allow the patient to remain active on the liver transplant list, increasing their chances of undergoing transplantation.

keywords:

hepatocellular carcinoma, liver transplant, liver-directed therapies, waiting list time
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2024 Termedia Sp. z o.o.
Developed by Bentus.