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Lower Willingness to Accept ECD Liver Transplantation

Standard-criteria donor may be more acceptable than expanded-criteria donor liver transplantation

WEDNESDAY, June 29 (HealthDay News) -- Patients are more willing to accept a standard criteria donor (SCD) than an expanded-criteria donor (ECD) liver transplantation (LTx), with one-third of patients having low willingness to accept ECD LTx, according to a study published online June 14 in the American Journal of Transplantation.

James R. Rodrigue, Ph.D., from the Beth Israel Deaconess Medical Center in Boston, and colleagues examined the willingness of patients to accept ECD LTx and what would constitute an acceptable one-year mortality risk. A total of 108 patients listed for LTx rated their willingness to accept ECD LTx and the related one-year mortality risk, and they completed the Short Form-36 version 2 (SF-36v2) to assess health-related quality of life. Patients' medical records were used to collect sociodemographic and health information.

The investigators found that patients reported being significantly more willing to accept standard-criteria donor (SCD) than ECD LTx, with low willingness to accept ECD LTx being reported by more than one-third of patients. Seventy-one percent of patients were willing to accept a one-year mortality risk for ECD LTx that was moderately or substantially higher than the center's 10 percent SCD LTx one-year mortality rate. Significant independent predictors of ECD willingness and ECD increased mortality risk acceptability were higher Model for End-Stage Liver Disease score and white race.

"Patients were significantly less willing to accept ECD versus SCD LTx," the authors write. "Most patients were willing to accept a one-year ECD LTx mortality risk that is higher than that expected for SCD LTx."

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