{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:04:26Z","timestamp":1790849066400,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T00:00:00Z","timestamp":1522022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T00:00:00Z","timestamp":1522022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>The tragedy of the national opioid epidemic has resulted in a significant increase in the number of opioid\u2010related deaths and accordingly an increase in the number of potential donors designated Public Health Service (PHS) increased risk. Previous studies have demonstrated reluctance to use these PHS organs, and as a result, higher discard rates for these organs have been observed. All patients listed for liver transplantation in the United States from January 2005 to December 2016 were investigated. Patients on the waiting list were divided into 2 groups: those in which a PHS liver was used for transplantation (accepted PHS group) and those in which a PHS liver was declined and transplanted into a recipient lower on the match run (declined PHS group). Intention\u2010to\u2010treat patient survival from the time of PHS offer was significantly higher in the accepted PHS compared with the declined PHS group (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). On Cox multivariate regression, declining a PHS donor liver was associated with a hazard ratio of 2.36 (95% confidence interval, 2.23\u20102.49; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). For patients in which a PHS organ offer was declined, 11.6% died or were delisted for being too sick within the subsequent year. Donor liver allografts implanted in the accepted PHS group were of a lower donor risk index (1.28 versus 1.44) compared with the non\u2010PHS organs that patients in the declined PHS group ultimately received if they underwent transplantation. In conclusion, there is a significantly higher survival for patients in which a PHS liver is accepted and used compared with those patients in which a PHS organ is declined. These data will help inform decisions about whether or not to accept a PHS donor liver for both patients and transplant professionals. <jats:italic toggle=\"yes\">Liver Transplantation 24 497\u2013504 2018<\/jats:italic> AASLD.<\/jats:p>","DOI":"10.1002\/lt.25009","type":"journal-article","created":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T09:12:39Z","timestamp":1516180359000},"page":"497-504","source":"Crossref","is-referenced-by-count":39,"title":["What are the outcomes of declining a public health service increased risk liver donor for patients on the liver transplant waiting list?"],"prefix":"10.1097","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7725-703X","authenticated-orcid":false,"given":"Kristopher P.","family":"Croome","sequence":"first","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surakit","family":"Pungpapong","sequence":"additional","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Keaveny","sequence":"additional","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Burcin","family":"Taner","sequence":"additional","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,3,26]]},"reference":[{"key":"lt25009-bib-0001-20240115","first-page":"1","article-title":"Guidelines for preventing transmission of human immunodeficiency virus through transplantation of human tissue and organs","volume":"43","year":"1994","journal-title":"Morbid Mortality Weekly Rep"},{"key":"lt25009-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1111\/j.1600-6143.2010.03329.x","article-title":"Risk of window period HIV infection in high infectious risk donors: systematic review and meta\u2010analysis","volume":"11","year":"2011","journal-title":"Am J Transplant"},{"key":"lt25009-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1111\/j.1600-6143.2011.03460.x","article-title":"Risk of 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Patient outcomes associated with declining increased infectious risk kidneys","volume":"18","year":"2017","journal-title":"Am J Transplant"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.25009","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201804000-00009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T01:12:29Z","timestamp":1705281149000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201804000-00009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,26]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.25009","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,26]]}}}