June 26, 2015
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Young, married patients listed for LT had high chance of finding live donor

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Patients waitlisted for liver transplant were more likely to find a living donor if they were young, married and had more severe disease compared with older individuals who were single, divorced or immigrants, according to study data published in Liver Transplantation.

“Given that the demand for liver transplantation is greater than the supply of deceased donor organs, there is an interest in increasing live donation at centers with experience in that method of transplantation,” Eberhard Renner, MD, FRCPC, University Health Network and University of Toronto in Ontario, Canada, said in a press release. “Our study aims to identify recipient characteristics that are associated with having a living donor volunteer for donation.”

Renner and colleagues analyzed data from 491 patients waitlisted for liver transplantation at the University of Toronto transplant center between January 2009 and December 2011. The researchers measured demographic, medical and socioeconomic data that came from an electronic records transplant database and compared patients who had a potential living donor volunteer for assessment with patients who did not.

Overall, 245 patients had at least one potential living donor. Of these patients, 70% were men and had an average age of 53 years. Patients listed for transplant were listed as a result of alcoholic liver disease (33.8%), 20.4% were listed due to HCV and 35% were listed because of HCC.

Multiple analysis showed that patients who had more access to a living donor were more likely to have Child-Pugh C compared with patients with less severe disease, such as Child-Pugh A (P = .02). Patients younger in age were also found to have more access to a living donor compared with older patients (P = .002).

Further analyses showed patients with limited or without access were likely to be single than married (OR = 0.34; 95% CI, 0.16-0.74); divorced (OR = 0.53; 95% CI, 0.3-0.94), immigrants (OR = 0.38; 95% CI, 0.14-0.99) or from the lowest income levels than the higher income quintiles (OR = .44; 95% CI, 0.22-0.85).

Multivariate analysis did not show an association between living donor access and MELD score, English as a first language or rural residence.

“More research is needed to understand and overcome the barriers to live donor liver transplants,” Renner said. “Possible interventions like financial assistance and educational programs may help increase liver donation from living donors.” – by Melinda Stevens

Disclosures: The researchers report no relevant financial disclosures.