Details

Autor(en) / Beteiligte

• Bajaj, Jasmohan S.
• Choudhury, Ashok
• Kumaran, Vinay
• Wong, Florence
• Seto, Wai Kay
• Alvares-Da-Silva, Mario Reis
• Desalgn, Hailemichael
• Hayes, Peter C.
• Idilman, Ramazan
• Topazian, Mark
• Torre, Aldo
• Xie, Qing
• George, Jacob
• Kamath, Patrick S.

Titel

Geographic disparities in access to liver transplant for advanced cirrhosis: Time to ring the alarm

Ist Teil von

• American journal of transplantation, 2024-05, Vol.24 (5), p.733-742

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2024

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Decompensated cirrhosis and hepatocellular cancer are major risk factors for mortality worldwide. Liver transplantation (LT), both live-donor LT or deceased-donor LT, are lifesaving, but there are several barriers toward equitable access. These barriers are exacerbated in the setting of critical illness or acute-on-chronic liver failure. Rates of LT vary widely worldwide but are lowest in lower-income countries owing to lack of resources, infrastructure, late disease presentation, and limited donor awareness. A recent experience by the Chronic Liver Disease Evolution and Registry for Events and Decompensation consortium defined these barriers toward LT as critical in determining overall survival in hospitalized cirrhosis patients. A major focus should be on appropriate, affordable, and early cirrhosis and hepatocellular cancer care to prevent the need for LT. Live-donor LT is predominant across Asian countries, whereas deceased-donor LT is more common in Western countries; both approaches have unique challenges that add to the access disparities. There are many challenges toward equitable access but uniform definitions of acute-on-chronic liver failure, improving transplant expertise, enhancing availability of resources and encouraging knowledge between centers, and preventing disease progression are critical to reduce LT disparities.