Navigation Links
Transplant candidates seek best quality livers, even if it means waiting longer
Date:12/1/2011

Liver transplantation candidates want to be involved in decisions regarding quality of the donor organ, and many are reluctant to accept organs with a higher risk of failure, according to research by U-M physicians and experts.

More than 42 percent of patients would choose to remain on the waiting list rather than accept a "lower quality" liver according to the study's lead author Michael L. Volk, M.D., M.S., assistant professor in U-M's Department of Internal Medicine, Division of Gastroenterology.

Research from Volk and his colleagues will appear in the December issue of Liver Transplantation, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases.

As of November 30, the Organ Procurement and Transplantation Network (OPTN) reports that 16,124 candidates are on the waiting list to receive a liver, with only 5,375 deceased donor organs recovered through August. Additionally, there is a large variation in quality of deceased donor livers, which is based on donor characteristics such as age, cause of death, and ischemia time. Previous research has shown that donor characteristics can make the difference between a 20 to 40 percent risk of graft failure by three years following transplantation.

"Organ quality is an important issue for all liver transplant candidates, increasingly so, given the aging donor pool and more frequent use of organs that carry a higher risk of failure," says Volk, who is a hepatology specialist.

"The decision to accept or pass on an organ could mean the difference between life and death for patients with end-stage liver disease. Communication of the risks versus benefits of accepting a 'lower quality' organ is critical, and understanding patient views on the subject is essential for physicians caring for transplant candidates."

For the current study, researchers tested presentation formats for communicating organ quality risks to patients, and factors that might influence patients' willingness to accept higher-risk organs. First, the team conducted interviews with ten patients on the waiting list for liver transplantation to determine their knowledge of organ quality and preferences for accepting organs with greater risk of failure. Based on qualitative information obtained from interviews, the team created a web-based survey which 95 candidates completed.

The findings show that patients are reluctant to accept higher-risk organs. Of those completing the survey, 58 percent would only accept organs with a 25 percent (or less) risk of graft failure and 18 percent would only accept the lowest possible risk of 19 percent at three years following transplantation.

Women were slightly more accepting of high-risk organs than men. Researchers found that risk tolerance was increased by presenting organ quality as "average quality" rather than "best quality," and by providing feedback about the implications of these preferences on the likelihood of receiving a transplant. Additionally, 83 percent of candidates were found to prefer an equal or dominant role in deciding whether to accept a higher-risk organ. This finding is striking given that, in most transplant centers, patient involvement in these decisions is minimal.

"Up until now, it has not been clear how much patients want to be involved in this complicated decision," says Volk.

"Furthermore, explaining the intricacies of this topic to sick patients is easier said than done. Our findings offer transplant physicians some useful guidelines for how to council transplant candidates on issues of organ quality."

The authors suggest future studies are needed to develop validated patient education tools that will enhance discussions between physicians and patients in need of liver transplantations.


'/>"/>
Contact: Mary Masson
mfmasson@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

Related medicine news :

1. Transplant candidates seek best quality livers despite having to remain on waiting list
2. Green tea flavonoid may prevent reinfection with hepatitis C virus following liver transplantation
3. Drug May Dampen Dangerous Side Effect of Stem Cell Transplants
4. Integrated 3-D imaging facilitates human face transplantation
5. Babies Put on Transplant List Before Birth Get Hearts Faster
6. Stem-Cell Transplants Restored Pituitary Function in Mice
7. Black Children Less Likely to Get Kidney Transplant Before Dialysis
8. Study Supports Shorter Wait Time for Alcoholics Seeking Liver Transplant
9. Adult living donor liver transplants safe, study finds
10. Cancer Risk Doubles After Organ Transplant, Study Finds
11. Mini Stem Cell Transplant May Help Seniors With Blood Cancer
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/5/2016)... NY (PRWEB) , ... February 05, 2016 , ... ... partners and setting the stage for new clinical and scientific initiatives have all ... year after she was appointed President and CEO of the nation’s oldest cancer ...
(Date:2/5/2016)... ... February 05, 2016 , ... Freed-Hardeman University President ... have signed a joint enrollment and degree completion agreement. The agreement, which ... baccalaureate degrees at FHU|Dickson. , The agreement allows students to be jointly ...
(Date:2/5/2016)... ... February 05, 2016 , ... The American public tends to feel uncomfortable about ... than regular municipal or well water. The recent experience with lead contaminated water in ... a long way toward increasing public acceptance of recycled waste water as drinking water. ...
(Date:2/5/2016)... ... February 05, 2016 , ... At its annual meeting held last week, ... of the National Board of Directors. Mr. McDermott succeeds former APDA Chairman, Fred Greene. ... Leslie A. Chambers , APDA President and CEO. “Pat has tirelessly served APDA since ...
(Date:2/5/2016)... ... February 05, 2016 , ... In sleep, when the ... a dream. A hallmark feature of patients with eating disorders is significant self-criticism, and ... disorder behaviors and obsessions are regarded as maladaptive means for coping with this unease, ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... , February 5, 2016 ... Today, VoicePower Ltd - The Speech Recognition People, announced their ... deployed to improve patient care, reduce turnaround times and to save ... CCG ,- VoicePower client since 2013 Challenge: --> ... Challenge: --> - Six doctors ,- Wirral CCG ,- ...
(Date:2/4/2016)... 4, 2016  The Senior Care Pharmacy Coalition ... Committee Chairman Jason Chaffetz (R-UT) and ... hearing , "Developments in the Prescription Drug ... growing questions about abusive pharmacy benefit manager (PBM) ... and Ranking Member Elijah Cummings (D-MD) are diligent, ...
(Date:2/4/2016)...  Montoya Love is recognized by Continental Who,s Who ... Montoya is the Regulatory Systems Operations Manager with ... Manufacturing and selling a broad range of ... healthcare institutions, clinical laboratories and life science researchers with ... globe. ...
Breaking Medicine Technology: