John P Roberts, Hyosun H Han, Dianne LaPointe Rudow, Elizabeth C Verna, Vineeta Kumar, Anjana Pillai, Adam D Griesemer, Gerald Scott Winder, James Trotter, Carrie Thiessen, Alisha Mavis, Michelle T Jesse, Daniela P Ladner, Elizabeth A Pomfret, David Mulligan, Josh Levitsky, Nicolas Goldaracena, Abhinav Humar, Swaytha Ganesh, AnnMarie Liapakis, Whitney E Jackson
Journal: Clinical transplantation 2023;37(7):e14954
PMID: 36892182
INTRODUCTION
Living donor liver transplantation (LDLT) is a promising option for mitigating the deceased donor organ shortage and reducing waitlist mortality. Despite excellent outcomes and data supporting expanding candidate indications for LDLT, broader uptake throughout the United States has yet to occur.
METHODS
In response to this, the American Society of Transplantation hosted a virtual consensus conference (October 18-19, 2021), bringing together relevant experts with the aim of identifying barriers to broader implementation and making recommendations regarding strategies to address these barriers. In this report, we summarize the findings relevant to the selection and engagement of both the LDLT candidate and living donor. Utilizing a modified Delphi approach, barrier and strategy statements were developed, refined, and voted on for overall barrier importance and potential impact and feasibility of the strategy to address said barrier.
RESULTS
Barriers identified fell into three general categories: 1) awareness, acceptance, and engagement across patients (potential candidates and donors), providers, and institutions, 2) data gaps and lack of standardization in candidate and donor selection, and 3) data gaps regarding post-living liver donation outcomes and resource needs.
CONCLUSIONS
Strategies to address barriers included efforts toward education and engagement across populations, rigorous and collaborative research, and institutional commitment and resources.
© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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