Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34682
Title: Impact of Share 35 liver transplantation allocation in Australia and New Zealand.
Austin Authors: Fink, Michael A ;Gow, Paul J ;McCaughan, Geoffrey W;Hodgkinson, Peter;Chen, John;McCall, John;Jaques, Bryon;Crawford, Michael;Strasser, Simone I;Hardikar, Winita;Brooke-Smith, Mark;Starkey, Graham M ;Jeffrey, Gary P;Gane, Ed;Stormon, Michael;Evans, Helen;Tallis, Caroline;Byrne, Amanda J;Jones, Robert M 
Affiliation: Surgery (University of Melbourne)
Victorian Liver Transplant Unit
University of Sydney, Sydney, New South Wales, Australia.;Liver Injury and Cancer, Centenary Institute, Camperdown, New South Wales, Australia.;Australian National Liver Transplant Unit, Royal Prince Alfred Hospital, Sydney, Australia.
Queensland Liver Transplant Service, Princess Alexandra Hospital and Queensland Children's Hospital, Brisbane, Australia.
Flinders Medical Centre, Adelaide, South Australia, Australia.
University of Auckland, Auckland, New Zealand.;New Zealand Liver Transplant Service, Auckland City Hospital, Auckland, New Zealand.
Western Australian Liver Transplant Unit, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
University of Sydney, Sydney, New South Wales, Australia.;Australian National Liver Transplant Unit, Royal Prince Alfred Hospital, Sydney, Australia.
Gastroenterology and Clinical Nutrition Department Royal Children's Hospital, Melbourne, Victoria, Australia.
Flinders Medical Centre, Adelaide, South Australia, Australia.
Western Australian Liver Transplant Unit, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.;Medical School, The University of Western Australia, Perth, Western Australia, Australia.
University of Auckland, Auckland, New Zealand.;New Zealand Liver Transplant Service, Auckland City Hospital, Auckland, New Zealand.
University of Sydney, Sydney, New South Wales, Australia.;Australian National Liver Transplantation Service, Children's Hospital at Westmead, Sydney, New South Wales, Australia.
University of Auckland, Auckland, New Zealand.;Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand.
Queensland Liver Transplant Service, Princess Alexandra Hospital and Queensland Children's Hospital, Brisbane, Australia.
Australia and New Zealand Liver and Intestinal Transplant Registry, Melbourne, Australia.
Issue Date: Jan-2024
Date: 2023
Publication information: Clinical Transplantation 2024-01; 38(1)
Abstract: Patients with high model for end-stage liver disease (MELD) scores waiting for liver transplantation in Australia and New Zealand (ANZ) have had limited access to deceased donor livers and therefore binational sharing of livers, for patients with a MELD score ≥35 was introduced in February 2016. Waiting list mortality, post-transplant outcomes and intention-to-treat survival were compared between patients whose MELD score reached 35 on the waiting list between October 2013 and April 2015 (Pre-Share 35 group, n = 23) and patients who were Share 35 listed between February 2016 and May 2022 (Share 35 group, n = 112). There was significantly reduced waiting list mortality in share 35 listed patients in comparison to the pre-Share 35 group (11.7% vs. 52.2%, OR .120 95% CI .044-.328, P < .001). Post-transplant patient and graft survival were not significantly different between the groups (5-year patient survival 82% vs. 84%, P = .991, 5-year graft survival 82% vs. 76%, P = .543). Intention-to-treat survival was superior in the Share 35 group (HR .302, 95% CI .149-.614, P < .001). Introduction of Share 35 in ANZ resulted in a 78% risk reduction in waiting list mortality, equivalent post-transplant survival and an improvement in intention-to-treat survival.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34682
DOI: 10.1111/ctr.15203
ORCID: 0000-0002-9684-4691
Journal: Clinical Transplantation
Start page: e15203
PubMed URL: 38088459
ISSN: 1399-0012
Type: Journal Article
Subjects: end stage liver disease
graft survival
mortality
survival
waiting lists
Appears in Collections:Journal articles

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