Don't miss out on the AST Journal Club -
Survival Benefit of Living-Donor Liver Transplant
Speakers: Dr Whitney Jackson & Dr John Malamon,
Moderators: Dr Ann Marie Liapakis & Dr Anjana Pillai
🗓️March 23rd
⏰ 2p ET
https://t.co/XKQi4nJKHV
#livertwitter
TODAY at noon: Medicine Grand Rounds with Drs. Pomfret and Jackson @WJacksonMD presenting: "Living Donor Liver Transplantation and the Rise of Altruism"
CME/MOC credit offered! Details and Zoom link: https://t.co/AWnNfHKY3K
Great #GIJC tonight with our moderators @HowardTLeeMD@MKriss_MD and expert @DrEmamaullee about the importance of LDLT and need to address disparities to expand access! #livertwitter Thank you for having me.
@GiJournal@amjtransplant@8pm@HowardTLeeMD @DrEmamaullee #GIJC Q6 (and final!): LDLT is still not as prevalent in the US compared to other countries. There are only 20 states with LDLT activity in 2019. What are the barriers and how can we address? Should we focus on developing high-volume LDLT centers in each state/region?
@MKriss_MD@GiJournal@amjtransplant@8pm@HowardTLeeMD @DrEmamaullee ABSOLUTELY! The worst place for a patient to be is on the waitlist. Ultimately recipient selection is complex and relies on a combination of deceased organ access, graft quality, recipient stability and center experience. U Toronto has excellent outcomes for high MELD patients
@MKriss_MD@GiJournal@amjtransplant@8pm@HowardTLeeMD @DrEmamaullee Barriers: general public and referring physician perceptions; socioeconomic; education; health insurance. We need to understand more!
Focusing on limited centers: most utilitarian approach but logistical limitations: our current revenue system; insurance out of network/state..
@MKriss_MD@GiJournal@amjtransplant@8pm@HowardTLeeMD @DrEmamaullee Standard exception MMT-3 means our HCC patients may be waiting without "climbing the ladder" the used to have in order to access organs. Another example of the importance of discussing access to organs with every patient when you first discuss transplant.
@MKriss_MD@GiJournal@amjtransplant@8pm@HowardTLeeMD @DrEmamaullee A5: Acuity Circles Policy aims to reduce geographic variation in medical urgency at time of transplant, but there are concerns that it will decrease access to deceased organs in areas with high donation rates. We will rely on LDLT more and more.
@MKriss_MD@GiJournal@amjtransplant@8pm@HowardTLeeMD @DrEmamaullee best measure of QOL, comparison pre/post txp, predictors.
Factors pre (HE, pruritus) and post (biliary) are not factored into our survival data yet affect our patients’ QOL significantly.