@Article{duepublico_mods_00076509,
  author = 	{Dancs, Peter T.
		and Saner, Fuat H.
		and Benk{\"o}, Tamas
		and Molmenti, Ernesto P.
		and B{\"u}chter, Matthias
		and Paul, Andreas
		and Hoyer, Dieter P.},
  title = 	{Balancing Outcome vs. Urgency in Modern Liver Transplantation},
  year = 	{2022},
  month = 	{Mar},
  day = 	{04},
  keywords = 	{Liver transplantation; Outcome; Waiting List; Urgency; Organ Allocation},
  abstract = 	{Background: Current allocation mechanisms for liver transplantation (LT) overemphasize emergency, leading to poorer longtime outcomes. The utility was introduced to recognized outcomes in allocation. Recently, Molinari proposed a predictive outcome model based on recipient data. Aims: The aims of this study were to validate this model and to combine it with the utility to emphasize outcome in allocation. Methods: We retrospectively analyzed 734 patients who were transplanted between January 2010 and December 2019. Points were assigned as in Molinari's model and the score sum was correlated with observed 90-day mortality. The utility was calculated as the product of 1-year survival times 3-month mortality on the waiting list. The weighting of different compounds was introduced, and utility curves were calculated. Model for End-Stage Liver Disease (MELD) scores according to maximal utility were determined. Results: In total, 120 patients (16.3{\%}) had died within 90 days after LT. Higher MELD score, obesity, and hemodialysis prior to LT were confirmed risk factors. Overall survival was 83.8 and 77.4{\%} after 90 days and 12 months, respectively. General utility culminated at MELD scores >35 in the overall population. Emphasizing the outcome shifted the maximal utility to lower MELD scores depending on Molinari scores. Conclusions: Emphasizing outcome, at least in certain recipient risk categories, might improve the longtime outcomes and might be integrated into allocation models.},
  note = 	{<p>Dancs PT, Saner FH, Benk{\"o} T, Molmenti EP, B{\"u}chter M, Paul A and Hoyer DP (2022) Balancing Outcome vs. Urgency in Modern Liver Transplantation. <em>Front. Surg.</em> 9:853727. <a href="https://doi.org/10.3389/fsurg.2022.853727">https://doi.org/10.3389/fsurg.2022.853727</a></p>

<p>Published: 04 March 2022</p>},
  note = 	{Version of Record / Verlagsversion},
  note = 	{<p>The publication of this article was supported by the Publication Fund of the University of Duisburg-Essen.</p>},
  doi = 	{10.3389/fsurg.2022.853727},
  url = 	{https://duepublico2.uni-due.de/receive/duepublico_mods_00076509},
  url = 	{https://doi.org/10.3389/fsurg.2022.853727},
  file = 	{:https://duepublico2.uni-due.de/servlets/MCRFileNodeServlet/duepublico_derivate_00076235/fsurg_2022-09-853727.pdf:PDF},
  language = 	{en}
}