A5035647126- Organ Transplantation Techniques and Outcomes
- Renal Transplantation Outcomes and Treatments
- Liver Disease and Transplantation
- Liver Disease Diagnosis and Treatment
- Organ Donation and Transplantation
- Renal and Vascular Pathologies
- Hepatocellular Carcinoma Treatment and Prognosis
- Cytomegalovirus and herpesvirus research
- Pregnancy and Medication Impact
- Intramuscular injections and effects
- Pulmonary Hypertension Research and Treatments
- COVID-19 Impact on Reproduction
- Heparin-Induced Thrombocytopenia and Thrombosis
- Diverse Legal and Medical Studies
- Blood donation and transfusion practices
- Transplantation: Methods and Outcomes
- Mast cells and histamine
- Drug-Induced Hepatotoxicity and Protection
- COVID-19 Clinical Research Studies
- Social and Demographic Issues in Germany
- Long-Term Effects of COVID-19
- Platelet Disorders and Treatments
Eurotransplant
2020-2025
Fundación Juan March
2023
The MELD score is used in the Eurotransplant (ET) region to allocate liver grafts. Hyponatremia cirrhotic patients an important predictor of death but not incorporated MELD. This study investigated performance MELD-Na for ET region. All adult with chronic disease on transplantation waiting list (WL) allocated through lab scores were included. MELD-corrected effect serum sodium (Na) concentration at listing 90-day WL mortality was calculated using Cox regression. assessed c-indices,...
In Eurotransplant, relatively more females than males die while waiting for liver transplantation, and fewer undergo transplantation. With adult transplantation candidates listed between 2007 2019 (n = 21 170), we study whether sex disparity is inherent to the model end-stage disease (MELD) scoring system, or indirect result of a small candidate body size limiting access Cox proportional hazard models are used quantify direct effect on waitlist mortality, independent through MELD scores,...
Rigid age limits in the current allocation system for post-mortem donor kidneys Germany may have problematic effects. The new German national transplantion registry enables data analysis with respect to this question. Using anonymized from registry, we extracted and evaluated information on recipients postmortem donors of that were allocated through Eurotransplant over period 2006-2020. Data 19 664 kidney transplantations 2006 2020 analyzed. median waiting time transplantation was 5.8 years....
Abstract Background Changes in recipient and donor factors have reopened the question of survival benefits kidney transplantation versus dialysis. Methods We analysed among 3808 adult Belgian patients waitlisted for a first deceased transplant from 2000 to 2012. The primary outcome was mortality during median waiting time plus 3 years follow-up after or with continued Outcomes were separately standard criteria (SCD) expanded (ECD) transplants. adjusted analyses age (20–44, 45–64 ≥65 years),...
On 24 January 2023, Eurotransplant has introduced the virtual crossmatch for kidney and pancreas allocation as a better alternative physical Complement Dependent Cytotoxicity (CDC) crossmatches at donor centre, which were associated with longer cold ischaemia time false positive reactions. For being, CDC recipient centre will remain in place final histocompatibility check. While is certainly not first organ organisation to introduce crossmatching, several novel aspects have been introduced,...
Background. Simultaneous pancreas-kidney transplantation (SPKT) is the therapy of choice for selected patients with complicated type 1 diabetes mellitus and end-stage renal disease. Pancreas rescue allocation was implemented in Eurotransplant algorithms to increase organ utilization, concurrently facilitating supposedly inferior quality organs. The aim this study examine whether outcomes SPKT after allocation, which can either be recipient-oriented extended or competitive were as good...
The presence of donor-specific HLA antibodies before transplantation is associated with poor outcomes. Unacceptable antigens can be assigned for Eurotransplant kidney transplant candidates to prevent offers against which the candidate has developed clinically relevant antibodies. This retrospective cohort study aimed assess what degree unacceptable affect access in Kidney Allocation System (ETKAS).Candidates who underwent kidney-only between 2016 and 2020 were included (n = 19 240). Cox...
Assignment of unacceptable HLA mismatches (UAMs) prevents transplantation incompatible grafts but potentially prolongs waiting time. Whether this is true in the Eurotransplant Kidney Allocation System (ETKAS) and Senior Program Germany highly debated relevant for UAM policies.Donor pool restriction due to was expressed as percent virtual panel-reactive antibodies (vPRAs). Kaplan-Meier estimates multivariable Cox regression models were used analyze impact vPRA levels on time transplant...
Abstract In Germany, organ allocation is based on the MELD-system and lab-MELD usually low in patients with hepatocellular carcinoma (HCC) cirrhosis. Higher medical urgency can be achieved by standard exception for HCC (SE-HCC), if Milan criteria (MC) are met. Noteworthy, UNOS T2 reflects MC, but excludes singular lesions < 2 cm. Thus, SE-HCC awarded to one lesion between 5 cm or 3 1 These static do not reflect biological properties of HCC. We present a retrospective cohort 111 patients,...
The United Network for Organ Sharing's Model End-Stage Liver Disease (UNOS-MELD) score is the basis of liver allocation in Eurotransplant region. It was constructed 20 years ago a small US cohort and has remained unchanged ever since. best boundaries coefficients were never calculated any region outside States. Therefore, this study refits MELD (reMELD) region.All adult patients listed first transplantation between January 1, 2007, December 31, 2018, included. Data randomly split training...
Background Little is known about the time-varying determinants of kidney graft failure in children. Methods We performed a retrospective study primary pediatric transplant recipients (younger than 18 years) from Eurotransplant registry (1990–2020). Piece-wise exponential additive mixed models were applied to analyze recipient, donor, and risk factors. Primary outcome was death-censored failure. Results report on 4528 transplantations, which 68% with deceased 32% living donor. One thousand...
Background. Whenever the kidney standard allocation (SA) algorithms according to Eurotransplant (ET) Kidney Allocation System or Senior Program fail, rescue (RA) is initiated. There are 2 procedurally different modes of RA: recipient oriented extended (REAL) and competitive (CRA). The objective this study was evaluate association patient survival graft failure with RA mode whether not it varied across ET countries. Methods. database retrospectively analyzed for donor clinical demographic...
Abstract Background Eurotransplant liver transplant candidates are prioritized by Model for End-stage Liver Disease (MELD), a 90-day waitlist survival risk score based on the INR, creatinine and bilirubin. Several studies revised original MELD score, UNOS-MELD, with candidate data modelling mortality from registration, censoring patients at delisting or transplantation. This approach ignores biomarkers reported after informative transplantation delisting. Methods We study how revision is...
Acute-on-chronic liver failure (ACLF) is usually associated with a precipitating event and results in the of other organ systems high short-term mortality. Current prediction models fail to adequately estimate prognosis need for transplantation (LT) ACLF. This study develops validates dynamic model patients ACLF that uses both longitudinal survival data.Adult on UNOS waitlist LT between 11.01.2016-31.12.2019 were included. Repeated end-stage disease-sodium (MELD-Na) measurements jointly...
Liver function is measured regularly in liver transplantation (LT) candidates. Currently, these previous disease development data are not used for survival prediction. By constructing and validating joint models (JMs), we aimed to predict the outcome based on all available data, using both severity its rate of change over time. Adult LT candidates listed Eurotransplant between 2007 2018 (n = 16 283) UNOS 2016 2019 30 533) were included. Patients with acute failure, exception points, or...
The utilization of liver allografts could be optimized if nonacceptance is predicted. This study aimed to evaluate the prognostic ability an updated Discard Risk Index in Eurotransplant.Potential deceased donors from January 2010 December 2015 who had been reported Eurotransplant were included our analyses. Liver was defined by transplant status as primary outcome performance Eurotransplant-developed Index.Of 11670 potential livers, 9565 (81%) actually transplanted. Donor sex, age, history...