{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:08:17Z","timestamp":1777496897621,"version":"3.51.4"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":155,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K08DK098272"],"award-info":[{"award-number":["K08DK098272"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:p>Donation after cardiac death (DCD) liver transplantation is associated with increased biliary complications and graft failure. Yet for unclear reasons, DCD recipients relisted for transplantation have lower wait\u2010list mortality than other retransplant candidates. We used Organ Procurement and Transplantation Network and United Network for Organ Sharing data from 2002 to 2011 to evaluate all DCD recipients relisted for transplantation to evaluate the impact of the utilization of Model for End\u2010Stage Liver Disease (MELD) exception points on wait\u2010list outcomes. Of 262 DCD recipients relisted for liver transplantation &gt;2 weeks after initial transplantation, 82 (31.3%) applied for a nonstandardized MELD exception, and 68 (82.9%) had \u22651 exception approved. Of the relisted DCD recipients, 187 (71.4%) underwent retransplantation; among those with an approved MELD exception, 85.2% underwent retransplantation versus 57.1% of those with an exception denied and 69.4% of those not applying for an exception (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.02). In contrast, those receiving MELD exception points were significantly less likely to be removed from the wait list for death or clinical deterioration in comparison with those not applying for an exception (7.1% versus 19.4%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.02). In multivariate models, patients with an approved exception were 3.3 times more likely to undergo retransplantation than those not applying for an exception. Standardized criteria for exception points among DCD recipients should be established to ensure uniform access to retransplantation. <jats:italic toggle=\"yes\">Liver Transpl 21:554\u2010560, 2015<\/jats:italic>. \u00a9 2015 AASLD.<\/jats:p>","DOI":"10.1002\/lt.24079","type":"journal-article","created":{"date-parts":[[2015,1,17]],"date-time":"2015-01-17T07:51:09Z","timestamp":1421481069000},"page":"554-560","source":"Crossref","is-referenced-by-count":11,"title":["Use of model for end\u2010stage liver disease exceptions for donation after cardiac death graft recipients relisted for liver transplantation"],"prefix":"10.1097","volume":"21","author":[{"given":"Richard C.","family":"Maduka","sequence":"first","affiliation":[{"name":"Perelman School of Medicine,University of Pennsylvania,Philadelphia,PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter L.","family":"Abt","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Hospital of the University of Pennsylvania,University of Pennsylvania,Philadelphia,PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine,University of Pennsylvania,Philadelphia,PA"},{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine,University of Pennsylvania,Philadelphia,PA"},{"name":"Leonard Davis Institute of Health Economics,University of Pennsylvania,Philadelphia,PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2015,3,30]]},"reference":[{"key":"lt24079-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1002\/lt.23732","article-title":"Center variation in the use of nonstandardized Model for End\u2010Stage Liver Disease exception points","volume":"19","year":"2013","journal-title":"Liver Transpl"},{"issue":"pt 2","key":"lt24079-bib-0002-20240115","first-page":"1003","article-title":"Liver transplantation in the United States, 1999\u20102008","volume":"10","year":"2010","journal-title":"Am J Transplant"},{"key":"lt24079-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1097\/MOT.0b013e32833991e3","article-title":"Current status of donation after cardiac death liver transplantation","volume":"15","year":"2010","journal-title":"Curr Opin Organ Transplant"},{"key":"lt24079-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/SLA.0b013e31818a080e","article-title":"Utilization, outcomes, and retransplantation of liver allografts from donation after cardiac death: implications for further expansion of the deceased\u2010donor pool","volume":"248","year":"2008","journal-title":"Ann Surg"},{"key":"lt24079-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/01.sla.0000103063.82181.2c","article-title":"Survival following liver transplantation from non\u2010heart\u2010beating donors","volume":"239","year":"2004","journal-title":"Ann Surg"},{"key":"lt24079-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1111\/ajt.12700","article-title":"Survival of recipients of livers from donation after circulatory death who are relisted and undergo retransplant for graft failure","volume":"14","year":"2014","journal-title":"Am J Transplant"},{"key":"lt24079-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1097\/01.sla.0000183973.49899.b1","article-title":"Utilization of extended donor criteria liver allografts maximizes donor use and patient access to liver transplantation","volume":"242","year":"2005","journal-title":"Ann Surg"},{"key":"lt24079-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"2652","DOI":"10.1111\/j.1600-6143.2010.03315.x","article-title":"Impact of MELD on waitlist outcome of retransplant candidates","volume":"10","year":"2010","journal-title":"Am J Transplant"},{"key":"lt24079-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1111\/j.1600-6143.2011.03969.x","article-title":"Lack of standardization in exception points for patients with primary sclerosing cholangitis and bacterial cholangitis","volume":"12","year":"2012","journal-title":"Am J Transplant"},{"key":"lt24079-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1002\/lt.23587","article-title":"Risk of waitlist mortality in patients with primary sclerosing cholangitis and bacterial cholangitis","volume":"19","year":"2013","journal-title":"Liver Transpl"},{"issue":"suppl 3","key":"lt24079-bib-0011-20240115","first-page":"S128","article-title":"Model for end\u2010stage liver disease (MELD) exception guidelines: results and recommendations from the MELD Exception Study Group and Conference (MESSAGE) for the approval of patients who need liver transplantation with diseases not considered by the standard MELD formula","volume":"12","year":"2006","journal-title":"Liver Transpl"},{"key":"lt24079-bib-0012-20240115","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1053\/he.2000.5852","article-title":"A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts","volume":"31","year":"2000","journal-title":"Hepatology"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.24079","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201504000-00015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T01:24:31Z","timestamp":1705281871000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201504000-00015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,30]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.24079","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,30]]}}}