Posts Tagged ‘allocation’

November 28, 2013

Class II HLA Epitope Matching—A Strategy to Minimize De Novo Donor-Specific Antibody Development and Improve Outcomes


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Although testing for HLA antibodies is long-established practice in transplantation, the immune system actually makes antibodies against specific epitopes, not antigens. This study used the HLA Matchmaker program to assess whether the degree of epitope mismatching predicted the development of post-transplant class II donor-specific antibodies. Thresholds for epitope mismatching at DR and DQ were found. […]

No Comments Posted in Renal Transplantation, Uncategorized
November 18, 2011

Overdose with suicidal intent: ethical considerations for liver transplant programs


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The authors discuss a case example of fulminant hepatic failure (FHF) in a patient who had attempted suicide by acetaminophen ingestion.  Opinions about eligibility for liver transplant (LT) vary, and the authors suggest patients with FHF due to suicide attempts should not be denied LT in the absence of any other obvious medical or overriding […]

No Comments Posted in Liver Transplantation
November 18, 2011

Better off living–the ethics of the new UNOS proposal for allocating kidneys for transplantation


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This article, part of CJASN’s new section on public policy, critically analyzes the new policy proposal by UNOS to allocate deceased donors kidneys in the UNOS.  The authors examine several potential objections: 1. Is waiting time a fair way to rank order patients since there are disparities in gaining access to listing? 2. It is […]

No Comments Posted in Renal Transplantation
November 18, 2011

MELD Exceptions and Rates of Waiting List Outcomes


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In this manuscript the authors examined the impact of MELD exception points. This is mostly commonly given to patients with hepatocellular carcinoma (HCC) who are on the waiting list. Liver transplantation for HCC continues to rise and in some centers approaches 30% of the waiting list. By awarding exception points, patients who are listed with […]

No Comments Posted in Liver Transplantation
July 4, 2011

The Model for End-Stage Liver Disease Allocation System for Liver Transplantation Saves Lives, but Increases Morbidity and Cost: A Prospective Outcome Analysis.


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Several provinces in Canada are moving to using the Model for End-Stage Liver Disease (MELD) score to allocate livers for transplantation. This paper assesses the impact of moving to the MELD score by comparing a cohort of patients from the pre-MELD to the MELD eras. Wait-list mortality was decreased, and one-year patient and graft survival […]

No Comments Posted in Liver Transplantation