Publicaciones científicas
First consensus document of waiting list prioritization for liver transplantation by the Spanish Society of Liver Transplantation (SETH)
Itxarone Bilbao 1 , Laura Lladó 2 , Alba Cachero 2 , Isabel Campos-Varela 1 , Jordi Colmenero 3 , Javier Del Hoyo 4 , Emilio Fábrega García 5 , Félix García-Pajares 6 , Luisa González Diéguez 7 , Rocío González Grande 8 , Ana Guiberteau Sánchez 9 , Francisco Hernández Oliveros 10 , José Ignacio Herrero Santos 11 , Sara Lorente 12 , Rosa Martín Mateos 13 , María José Mesa López 14 , José Luis Montero Álvarez 15 , Carolina Muñoz Codoceo 16 , Alejandra Otero Ferreiro 17 , Elena Otón Nieto 18 , María Rodríguez Soler 19 , Mario Romero Cristóbal 20 , Lidia Sastre Oliver 21 , María Senosiain Labiano 22 , José Manuel Sousa Martín 23 , María Trapero-Marugán 24 , Evaristo Varo 25 , Gloria de la Rosa 26 , Manuel Rodríguez-Perálvarez 27
Abstract
Spain is worldwide leader in deceased donation rates per million habitants and count on a strong network of twenty-five liver transplant institutions.
Although the access to liver transplantation is higher than in other countries, approximately 10% of patients qualifying for liver transplantation in Spain will die in the waiting list or would be excluded due to clinical deterioration. A robust waiting list prioritization system is paramount to grant the sickest patients with the first positions in the waiting list for an earlier access to transplant.
In addition, the allocation policy may not create or perpetuate inequities, particularly in a public and universal healthcare system. Hitherto, Spain lacks a unique national allocation system for elective liver transplantation. Most institutions establish their own rules for liver allocation and only two autonomous regions, namely Andalucía and Cataluña, share part of their waiting list within their territory to provide regional priority to patients requiring more urgent transplantation.
This heterogeneity is further aggravated by the recently described sex-based disparities for accessing liver transplantation in Spain, and by the expansion of liver transplant indications, mainly for oncological indications, in absence of clear guidance on the optimal prioritization policy.
The present document contains the recommendations from the first consensus of waiting list prioritization for liver transplantation issued by the Spanish Society of Liver Transplantation (SETH).
The document was supported by all liver transplant institutions in Spain and by the Organización Nacional de Trasplantes (ONT). Its implementation will allow to homogenize practices and to improve equity and outcomes among patients with end-stage liver disease.
CITA DEL ARTÍCULO Rev Esp Enferm Dig. 2024 Sep 13. doi: 10.17235/reed.2024.10639/2024
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