scholarly journals Delayed hepatocellular carcinoma model for end-stage liver disease exception score improves disparity in access to liver transplant in the United States

Hepatology ◽  
2015 ◽  
Vol 61 (5) ◽  
pp. 1643-1650 ◽  
Author(s):  
Julie K. Heimbach ◽  
Ryutaro Hirose ◽  
Peter G. Stock ◽  
David P. Schladt ◽  
Hui Xiong ◽  
...  
2015 ◽  
Author(s):  
Andreea M. Catana ◽  
Michael P. Curry

The first liver transplantation (LT) was performed in 1963, and currently more than 65,000 people in the United States are living with a transplanted liver. In 2012, the number of adults who registered on the LT waiting list decreased for the first time since 2002; 10,143 candidates were added compared with 10,359 in 2011. LT offers long-term survival for complications of end-stage liver disease and prolongs life in properly selected patients, but problems such as donor deficit, geographic disparities, and long waiting lists remain. This overview of LT for the gastroenterologist details the indications for LT and patient selection, evaluation, liver organ allocation, prioritization for transplantation, transplantation benefit by the Model for End-Stage Liver Disease (MELD), MELD limitations, sources of liver graft, strategies employed to decrease the donor deficit, complications, and outcomes. Figures include indications for LT in Europe and the United States, Organ Procurement and Transplantation Network regions in the United States, the number of transplants and size of active waiting lists, mortality by MELD, regional disparity, patient survival rates with and without hepatitis C virus, and unadjusted patient and graft survival. Tables list LT milestones, indications for LT, contraindications for LT, minimal listing criteria for LT, criteria for LT in acute liver failure, LT evaluation process, adult recipient listing status 1A, and early posttransplantation complications. This review contains 7 highly rendered figures, 8 tables, and 46 references. 


2015 ◽  
Author(s):  
Amy R. Evenson ◽  
Ramanathan M. Seshadri ◽  
Jonathan P. Fryer

The number of patients with end-stage organ disease in the United States is substantial. Patients with end-stage organ disease are susceptible to all of the surgical problems seen in general surgical practice, with the added comorbidities associated with their organ failure. Hence, understanding of the principles of perioperative patient management is important as part of a general surgery practice. The chapter contains details on general and peripheral vascular surgical procedures, including dialysis access for patients with end-stage renal disease. Details on management of abdominal hernias, cholelithiasis, and disorders of the intestine in patients with end-stage liver disease are provided. Table 1 discusses the advantages and disadvantages of arteriovenous (AV) fistulas versus AV grafts. Table 2 describes “the rule of 6’s” for mature AV fistula. Table 3 has information on potential barriers to peritoneal dialysis. Table 4 is the Child-Pugh-Turcotte classification of severity of liver disease. Table 5 discusses the factors affecting the decision to operate and timing of operation in patients with end-stage liver disease. Figure 1 shows the increasing incidence of end-stage renal disease in the United States. Figure 2 is the five-stage classification system for chronic kidney disease. Figure 3 illustrates the various options for upper extremity AV fistula. This review contains 3 figures, 5 tables, and 68 references.


2012 ◽  
Vol 18 (12) ◽  
pp. 1456-1463 ◽  
Author(s):  
Pratima Sharma ◽  
Douglas E. Schaubel ◽  
Emily E. Messersmith ◽  
Mary K. Guidinger ◽  
Robert M. Merion

2019 ◽  
Vol 25 (9) ◽  
pp. 1321-1332 ◽  
Author(s):  
Katherine H. Ross ◽  
Rachel E. Patzer ◽  
David Goldberg ◽  
Nicolas H. Osborne ◽  
Raymond J. Lynch

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