Longer Term Follow-up on Acuity Circle Allocation Strategies in Liver Transplantation-Reference-Cited by-同舟云学术

Longer Term Follow-up on Acuity Circle Allocation Strategies in Liver Transplantation

Published:2024-04-24 Issue:2 Volume:11 Page:77-83
ISSN:2196-3029
Container-title:Current Transplantation Reports
language:en
Short-container-title:Curr Transpl Rep

Author:

Kwong Allison J.,Jowell Ashley,Bambha Kiran,Biggins Scott W.

Abstract

Abstract Purpose of Review This review summarizes longer term follow-up of acuity circle–based distribution for livers, which was implemented on February 4, 2020. Recent Findings After 2 years of policy implementation, the likelihood of transplant increased, while removals for death or being too sick decreased. The median transplant score was unchanged, and the variance in the median MELD at transplant decreased for OPTN regions, DSA, and state. Concurrently, median distance from donor to transplant hospital and cold ischemia times increased. A slight increase in liver non-use rate and decrease in liver utilization rate has been observed. Summary Acuity circle–based distribution improved access to liver transplantation for the sickest patients through broader sharing, at the cost of increased travel and logistics. The continuous distribution framework may be an opportunity for the liver transplant community to further address geographic disparities in access to transplant in the United States.

Funder

National Institute on Alcohol Abuse and Alcoholism

Publisher

Springer Science and Business Media LLC

Link

https://link.springer.com/content/pdf/10.1007/s40472-024-00432-w.pdf

Reference17 articles.

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5. OPTN Liver & Intestinal Transplantation Committee. Two year monitoring report of liver and intestine acuity circle allocation removal of DSA and region as units of allocation. 2022. Available from: https://optn.transplant.hrsa.gov/media/k5yi4jvl/data_report_liver_full_2yrallocation_20220805_final_508_compliant.pdf. This OPTN report summarizes the 2-year impact of acuity circle implementation on liver transplant allocation. Key findings include increased transplant rates for patients with MELD/PELD ≥29, increased median distance from donor hospital to transplant hospital, and no significant change in post-transplant survival.