Date: Sunday, June 12, 2016
Session Name: Poster Session B: Disparities in Access and Outcomes
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: There is paucity of Level A evidence of consistent listing criteria and Liver Transplant in Jehovah Witness (JW) patients. London Health Sciences Centre (LHSC) has been following an Institutional Criteria for listing JW patients on the waiting lists. LHSC receives all Canadian referrals as it is the only centre offering Liver Transplant for JW at present.
Aims: To assess the outcomes of Listing Criteria and Liver Transplant in JW patients at LHSC between 01 Jan 1995- 01 Jan 2015.
Methods: London Criteria includes standard UNOS listing criteria for Liver Transplantation plus 1. Age < 65 yr.; 2. BMI < 40 ; 3. INR <1.5 ; 4. Hb >100 g/L ; 5. Platelets > 100 x 109/L ; 6. Not on anti-coagulants. Patients were list deactivated , when they were outside criteria. Peri LT, blood conservation strategies including Cell Saver, plasma expander, immunoglobulins and albumin were placed to resuscitate the patient in event of blood loss. Referral record, hematinics, post-operative Liver functions, operative record , graft/patient survival data were extracted from [copy] Power Chart.
Results: 17 referrals were made. 11/17 were activated on waiting list. 06/11 (02 pediatric/4 adult) patients had LT. Median age at listing and transplanted patients was 52 ± 21.9 yr & 48.5± 23.1 yr respectively for adults.05/06 patients had cadaveric LT. Median wait time on waiting list prior to transplant was 7.5 months (range 01-24 months). 09 %( 01/11) listed patients died awaiting transplant. Aetiology of liver disease were varied ; Adults (2 HCV, 1 HBV, 1 PBC); Children (Biliary Atresia, Alagille's syndrome). Intra-operatively recipients received an average of 750 ml of their own blood via cell-saver. Post-operatively 01/06 patients required EPO and IV iron therapy (Hb=21g/L). There were no episodes of major surgical bleeding. The median Hb pre Transplant and immediate post-transplant was 11.5 ± 1.3g/L , 8.4±1.4 g/L (p=0.18) respectively. 1 year graft survival and 1 year patient survival was 100%, 5 year death censored graft survival and 5 year patient survival was 100%; 83.3% respectively.
Conclusion: London Criteria is effective in screening and activating suitable JW patients on the waiting list. Due to strict adherence to London Criteria and experience of LT in JW, the patient/graft outcomes at our Centre are comparable to the published evidence.
CITATION INFORMATION: Sharma H, Al-Hasan I, Pineda-Solis K, Tun M, Marotta P, Quan D, Levstik M. London Criteria for Listing Potential Liver Transplant Jehovah's Witness (JW) Patients. A Single Centre Results of Listing and Liver Transplant (LT) in JW Patients in Canada. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Sharma H, Al-Hasan I, Pineda-Solis K, Tun M, Marotta P, Quan D, Levstik M. London Criteria for Listing Potential Liver Transplant Jehovah's Witness (JW) Patients. A Single Centre Results of Listing and Liver Transplant (LT) in JW Patients in Canada. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/london-criteria-for-listing-potential-liver-transplant-jehovahs-witness-jw-patients-a-single-centre-results-of-listing-and-liver-transplant-lt-in-jw-patients-in-canada/. Accessed March 4, 2021.
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