{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:18:06Z","timestamp":1790403486739,"version":"4.1.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006005","name":"Agence de la Biom\u00e9decine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:p>In France, the main indications for liver transplantation are hepatocellular carcinoma (HCC) and alcoholic cirrhosis. The number of candidates for decompensated hepatitis C virus\u2013related cirrhosis has markedly decreased since the advent of direct\u2010acting antiviral agents. Nonalcoholic steatohepatitis represents a lower proportion of candidates as compared with the United States. The main source of donors is donation after brain death, but the program of transplantation using donation after circulatory death is growing with excellent results. The deceased donation rate was 28.8\u00a0per million people in 2017, which has increased over the last few years. Adult\u2010to\u2010adult living donor liver transplantation has been almost completely abandoned. Donors are allocated on a national basis, and there is no longer local or regional priority. In patients with decompensated cirrhosis, prioritization is based on the Model for End\u2010Stage Liver Disease (MELD) score. The distance between the donor and the recipient is taken into account according to an original gravity model. In patients with HCC, prioritization depends on the alfa\u2010fetoprotein (AFP) score, the MELD score, and waiting time. Only patients with HCC tumor\u2010node\u2010metastasis\u00a0\u22652 and AFP score\u00a0\u22642 are eligible for the HCC score. A list of MELD exceptions, consisting of uncommon complications where mortality risk is not adequately predicted by the MELD score and conditions other than cirrhosis, has been established. MELD exceptions must be individually validated by a college of experts mandated by the French Regulatory Agency of Transplantation (Agence de la Biom\u00e9decine). The most common MELD exception is refractory ascites with a low MELD score. A major challenge is to reduce the rate of refusal of donation through information campaigns.<\/jats:p>","DOI":"10.1002\/lt.25419","type":"journal-article","created":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T06:01:04Z","timestamp":1548828064000},"page":"763-770","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Liver Transplantation in France"],"prefix":"10.1097","volume":"25","author":[{"given":"Fran\u00e7ois","family":"Durand","sequence":"first","affiliation":[{"name":"Hepatology and Liver Intensive Care,Hospital Beaujon,Clichy,France"},{"name":"University Paris Diderot,Paris,France"},{"name":"INSERM U1149,Paris,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Antoine","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation,Hospital Saint Louis,Paris,France"},{"name":"Agence de la Biom\u00e9decine,Saint Denis,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Soubrane","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary, Liver Transplantation, and Pancreatic Surgery,Hospital Beaujon,Clichy,France"},{"name":"University Paris Diderot,Paris,France"},{"name":"INSERM U1149,Paris,France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,4,1]]},"reference":[{"key":"lt25419-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jhep.2018.05.011","article-title":"Burden of liver disease in Europe: Epidemiology and analysis of risk factors to identify prevention policies","volume":"69","year":"2018","journal-title":"J Hepatol"},{"key":"lt25419-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1053\/j.gastro.2014.11.039","article-title":"Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults 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