Liver transplantation is a life-saving procedure for patients with end-stage liver disease. However, due to the shortage of donor organs, there is an inherent wait time for patients to receive a liver transplant. A recent study has shed light on the fact that smaller liver transplant candidates are waiting up to 55 days longer than other recipients, despite being in urgent need. This delay in transplantation can have serious consequences for these patients, highlighting the need for improved allocation and prioritization of organs. In this article, we’ll explore the reasons behind this disparity and what can be done to address it.
A recent study published in JAMA Surgery has found that, although body size affects the process of liver transplantation, women are mostly affected. Liver transplant candidates who are small-statured face longer waitlist times and lower rates of transplants, according to the research. The smallest 25% of candidates were affected the most. The study was conducted using data from 41,341 donors and 84,201 waitlist candidates. The researchers discovered that candidates with the lowest body surface area (BSA) waited 55 days longer than those with the highest BSA. Researchers found that allocation policies should prioritise matching small donors with small recipients, as such policies would overcome the disparities revealed in this study.
Catherine E. Kling, MD, MPH, one of the study’s authors and an assistant professor in the division of transplant surgery and program director for the Abdominal Transplant Surgery Fellowship at the University of Washington, said that the liver transplant community is rethinking the process of allocating livers to candidates on the waitlist. This is because small stature has been identified as a risk factor for not getting a transplant. The liver transplant community is proposing small stature as a factor to be included in the new allocation model.
Although there is uncertainty about whether height or BSA is the best way to identify small candidates and donors with small livers or whether a better measure exists, the researchers suggested that new policy solutions that “direct the smallest 10% of livers to the smallest 15% of candidates” would overcome this disparity. Such solutions could help identify small candidates at risk, donors with small livers that could benefit them, and how to match them.
In conclusion, the wait for a liver transplant can be a daunting and emotionally draining experience. For those who are smaller in size, the wait can be even longer than their larger counterparts. While this disparity may seem unfair, it is a reflection of the complex nature of organ transplantation and the need to match donors and recipients as perfectly as possible. The good news is that smaller patients are not being overlooked and are still receiving the necessary care and attention they need. It is our hope that this article can help raise awareness about the challenges facing smaller liver transplant candidates and encourage more people to consider organ donation. Every donation, no matter how small, can make a huge difference in someone’s life.
