Mortality Determinants in Children with Biliary Atresia Awaiting Liver Transplantation - 17/12/20
Abstract |
Objective |
To determine risk factors for waitlist mortality in children with biliary atresia listed for liver transplantation.
Study design |
There were 2704 children with biliary atresia (<12 years of age) listed for a first liver transplant (2002-2018) in the United Network for Organ Sharing database. Fine-Gray regression models for competing risks analysis (main risk = waitlist mortality/delisting owing to too sick; competing risk = liver transplantation) were implemented to identify risk factors for waitlist mortality.
Results |
The median waitlist time was 83 days (IQR, 34-191). The cumulative incidence of waitlist mortality was 5.2%. In multivariable analysis (n = 2253), increasing bilirubin level (P < .001), portal vein thrombosis (P = .03), and ventilator dependence (P < .001) at listing were associated with a higher risk, whereas weight ≥10 kg at listing (P = .009) was associated with a lower risk of waitlist mortality. When ascites at listing was included in multivariable analysis (n = 1376), it was associated with a higher risk for the composite outcome (P = .03). Encephalopathy at listing was not associated with waitlist mortality (n = 1376; P = .15).
Conclusions |
These parameters can be used to more objectively prioritize children with biliary atresia awaiting liver transplantation and identify children with biliary atresia-related end-stage liver disease at high-risk of mortality.
Le texte complet de cet article est disponible en PDF.Keywords : competing risks regression, waitlist mortality, pediatric transplantation, PELD score, organ allocation
Abbreviations : ESLD, INR, PELD, PVT, sHR, SPLIT, UNOS
Plan
| Supported in part by Health Resources and Services Administration contract 234-2005-370011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The authors declare no conflicts of interest. |
Vol 228
P. 177-182 - janvier 2021 Retour au numéro
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