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. 2023 Jul;37(7):e14967.
doi: 10.1111/ctr.14967. Epub 2023 Mar 20.

A survey of transplant providers regarding attitudes, barriers, and facilitators to living donor liver transplantation in the United States

AnnMarie Liapakis  1 , Uchenna Agbim  2 , Therese Bittermann  3 , Mary Amanda Dew  4 , Yanhong Deng  5 , Geliang Gan  5 , Sukru Emre  6 , Heather F Hunt  7 , Kim M Olthoff  3 , Jayme E Locke  8 , Michelle T Jesse  9 , Vineeta Kumar  8 , Anjana Pillai  10 , Elizabeth Verna  11 , Krista L Lentine  2 ; AST LDLT Consensus Conference Working Group
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A survey of transplant providers regarding attitudes, barriers, and facilitators to living donor liver transplantation in the United States

AnnMarie Liapakis et al. Clin Transplant. 2023 Jul.

Abstract

Introduction: A successful living donor liver transplant (LDLT) is the culmination of a multifaceted process coordinated among key stakeholders.

Methods: We conducted an electronic survey of US liver transplant (LT) centers (August 26, 2021-October 10, 2021) regarding attitudes, barriers, and facilitators of LDLT to learn how to expand LDLT safely and effectively in preparation for the American Society of Transplantation Living Donor Liver Transplant Consensus Conference.

Results: Responses were received from staff at 58 programs (40.1% of US LT centers). There is interest in broadening LDLT (100% of LDLT centers, 66.7% of non-LDLT centers) with high level of agreement that LDLT mitigates donor shortage (93.3% of respondents) and that it should be offered to all suitable candidates (87.5% of respondents), though LDLT was less often endorsed as the best first option (29.5% of respondents). Key barriers at non-LDLT centers were institutional factors and surgical expertise, whereas those at LDLT centers focused on waitlist candidate and donor factors. Heterogeneity in candidate selection for LDLT, candidate reluctance to pursue LDLT, high donor exclusion rate, and disparities in access were important barriers.

Conclusion: Findings from this study may help guide current and future expansion of LDLT more efficiently in the US. These efforts require clear and cohesive messaging regarding LDLT benefits, engagement of the public community, and dedicated resources to equitably increase LDLT access.

Keywords: access; disparities; liver transplantation; living donation; practice variation; surveys.

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References

REFERENCES

    1. Olthoff KM, Smith AR, Abecassis M, et al. Defining long-term outcomes with living donor liver transplantation in North America. Ann Surg. 2015;262(3):465-475. discussion 473-5. doi:10.1097/SLA.0000000000001383
    1. Organ Procurement and Transplantation Network. Advanced Data Report Builder. Accessed at: Last Accessed March 27, 2022. https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/
    1. Lentine KL, Tanaka T, Xiao H, et al. Variation in adult living donor liver transplantation in the united states: identifying opportunities for increased utilization. Clin Transplant. 2023:e14924. doi:10.1111/ctr.14924
    1. Rela M, Rammohan A. Why are there so many liver transplants from living donors in Asia and so few in Europe and the US? J Hepatol. 2021;75(4):975-980. doi:10.1016/j.jhep.2021.05.036
    1. Kwong AJ, Ebel NH, Kim WR, et al. OPTN/SRTR 2020 annual data report: liver. Am J Transplant. 2022;22(2):204-309. doi:10.1111/ajt.16978. Suppl.

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