Impact of Share 35 liver transplantation allocation in Australia and New Zealand

Michael A Fink; Paul J Gow; Geoffrey W McCaughan; Peter Hodgkinson; John Chen; John McCall; Bryon Jaques; Michael Crawford; Simone I Strasser; Winita Hardikar; Mark Brooke-Smith; Graham Starkey; Gary P Jeffrey; Ed Gane; Michael Stormon; Helen Evans; Caroline Tallis; Amanda J Byrne; Robert M Jones

doi:10.1111/ctr.15203

Impact of Share 35 liver transplantation allocation in Australia and New Zealand

Michael A Fink, Paul J Gow, Geoffrey W McCaughan, Peter Hodgkinson, John Chen, John McCall, Bryon Jaques, Michael Crawford, Simone I Strasser, Winita Hardikar, Mark Brooke-Smith, Graham Starkey, Gary P Jeffrey, Ed Gane, Michael Stormon, Helen Evans, Caroline Tallis, Amanda J Byrne, Robert M Jones

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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.

Original language	English
Article number	e15203
Number of pages	10
Journal	CLINICAL TRANSPLANTATION
Volume	38
Issue number	1
Early online date	13 Dec 2023
DOIs	https://doi.org/10.1111/ctr.15203
Publication status	Published - Jan 2024
Externally published	Yes

Keywords

end stage liver disease
graft survival
mortality
survival
waiting lists

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10.1111/ctr.15203Licence: CC BY-NC-ND

Final published versionFinal published version, 491 KBLicence: CC BY-NC-ND

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Fink, M. A., Gow, P. J., McCaughan, G. W., Hodgkinson, P., Chen, J., McCall, J., Jaques, B., Crawford, M., Strasser, S. I., Hardikar, W., Brooke-Smith, M., Starkey, G., Jeffrey, G. P., Gane, E., Stormon, M., Evans, H., Tallis, C., Byrne, A. J., & Jones, R. M. (2024). Impact of Share 35 liver transplantation allocation in Australia and New Zealand. CLINICAL TRANSPLANTATION, 38(1), Article e15203. https://doi.org/10.1111/ctr.15203

@article{3409bd2c2b3d462c99f3493713fda756,

title = "Impact of Share 35 liver transplantation allocation in Australia and New Zealand",

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.",

keywords = "end stage liver disease, graft survival, mortality, survival, waiting lists",

author = "Fink, {Michael A} and Gow, {Paul J} and McCaughan, {Geoffrey W} and Peter Hodgkinson and John Chen and John McCall and Bryon Jaques and Michael Crawford and Strasser, {Simone I} and Winita Hardikar and Mark Brooke-Smith and Graham Starkey and Jeffrey, {Gary P} and Ed Gane and Michael Stormon and Helen Evans and Caroline Tallis and Byrne, {Amanda J} and Jones, {Robert M}",

year = "2024",

month = jan,

doi = "10.1111/ctr.15203",

language = "English",

volume = "38",

journal = "CLINICAL TRANSPLANTATION",

issn = "0902-0063",

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number = "1",

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Fink, MA, Gow, PJ, McCaughan, GW, Hodgkinson, P, Chen, J, McCall, J, Jaques, B, Crawford, M, Strasser, SI, Hardikar, W, Brooke-Smith, M, Starkey, G, Jeffrey, GP, Gane, E, Stormon, M, Evans, H, Tallis, C, Byrne, AJ & Jones, RM 2024, 'Impact of Share 35 liver transplantation allocation in Australia and New Zealand', CLINICAL TRANSPLANTATION, vol. 38, no. 1, e15203. https://doi.org/10.1111/ctr.15203

TY - JOUR

T1 - Impact of Share 35 liver transplantation allocation in Australia and New Zealand

AU - Fink, Michael A

AU - Gow, Paul J

AU - McCaughan, Geoffrey W

AU - Hodgkinson, Peter

AU - Chen, John

AU - McCall, John

AU - Jaques, Bryon

AU - Crawford, Michael

AU - Strasser, Simone I

AU - Hardikar, Winita

AU - Brooke-Smith, Mark

AU - Starkey, Graham

AU - Jeffrey, Gary P

AU - Gane, Ed

AU - Stormon, Michael

AU - Evans, Helen

AU - Tallis, Caroline

AU - Byrne, Amanda J

AU - Jones, Robert M

PY - 2024/1

Y1 - 2024/1

N2 - 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.

AB - 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.

KW - end stage liver disease

KW - graft survival

KW - mortality

KW - survival

KW - waiting lists

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U2 - 10.1111/ctr.15203

DO - 10.1111/ctr.15203

M3 - Article

C2 - 38088459

AN - SCOPUS:85179366396

SN - 0902-0063

VL - 38

JO - CLINICAL TRANSPLANTATION

JF - CLINICAL TRANSPLANTATION

IS - 1

M1 - e15203

ER -

Impact of Share 35 liver transplantation allocation in Australia and New Zealand

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Keywords

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