The sickest liver transplant candidates should be first in line when a donor liver becomes available, but transplant centers are increasingly removing these individuals from the waiting list, considering them "too sick to transplant," an analysis of nationwide transplant data finds. The study appears online as an "article in press" on the Journal of the American College of Surgeons website in advance of print publication.
Between mid-2007 and 2012, more than 4,300 Americans with life-threatening liver diseases were taken off the transplant waiting list, or "delisted," because of deteriorating illness as determined by their transplant center, study authors reported. That number was nearly twice the 2,311 liver transplant candidates delisted between April 2002 and June 2007 because of reported illness severity.
"The central tenet of liver transplant allocation is to prioritize the sickest patients first," said the study's senior investigator Adel Bozorgzadeh, MD, FACS, a transplant surgeon at UMass Memorial Medical Center in Worcester, Mass. "Yet, more and more patients who could potentially benefit from a liver transplant are being denied this lifesaving procedure." Continue reading
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