Liver Transplantation for T2 Hepatocellular Carcinoma during the COVID-19 Pandemic: A Novel Model Balancing Individual Benefit against Healthcare Resources
The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in...
Ausführliche Beschreibung
Autor*in: |
Umberto Cillo [verfasserIn] Alessandro Vitale [verfasserIn] Michael L. Volk [verfasserIn] Anna Chiara Frigo [verfasserIn] Paolo Feltracco [verfasserIn] Annamaria Cattelan [verfasserIn] Giuseppina Brancaccio [verfasserIn] Giuseppe Feltrin [verfasserIn] Paolo Angeli [verfasserIn] Patrizia Burra [verfasserIn] Sara Lonardi [verfasserIn] Silvia Trapani [verfasserIn] Massimo Cardillo [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2021 |
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Übergeordnetes Werk: |
In: Cancers - MDPI AG, 2010, 13(2021), 6, p 1416 |
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Übergeordnetes Werk: |
volume:13 ; year:2021 ; number:6, p 1416 |
Links: |
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DOI / URN: |
10.3390/cancers13061416 |
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Katalog-ID: |
DOAJ054135850 |
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10.3390/cancers13061416 doi (DE-627)DOAJ054135850 (DE-599)DOAJ6c55da21b3104bb4bf45bcc7a1394aa6 DE-627 ger DE-627 rakwb eng RC254-282 Umberto Cillo verfasserin aut Liver Transplantation for T2 Hepatocellular Carcinoma during the COVID-19 Pandemic: A Novel Model Balancing Individual Benefit against Healthcare Resources 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in liver transplantation for T2 HCC. We proposed a novel ethical framework where the individual transplant benefit for a T2 HCC patient should outweigh the harm to others on the waiting list, determining a “net benefit”, to define appropriate organ allocation. This ethical framework was then translated into a quantitative Markov model including Italian averages for waiting list characteristics, donor resources, mortality, and transplant rates obtained from a national prospective database (n = 8567 patients). The net benefit of transplantation in a T2 HCC patient in a usual situation varied from 0 life months with a model for end-stage liver disease (MELD) score of 15, to 34 life months with a MELD score of 40, while it progressively decreased with acute organ shortage during a pandemic (i.e., with a 50% decrease in organs, the net benefit varied from 0 life months with MELD 30, to 12 life months with MELD 40). Our study supports the continuation of transplantation for T2 HCC patients during crises such as COVID-19; however, the focus needs to be on those T2 HCC patients with the highest net survival benefit. liver transplantation T2 HCC COVID-19 pandemic organ allocation transplant benefit waiting list harm Neoplasms. Tumors. Oncology. Including cancer and carcinogens Alessandro Vitale verfasserin aut Michael L. Volk verfasserin aut Anna Chiara Frigo verfasserin aut Paolo Feltracco verfasserin aut Annamaria Cattelan verfasserin aut Giuseppina Brancaccio verfasserin aut Giuseppe Feltrin verfasserin aut Paolo Angeli verfasserin aut Patrizia Burra verfasserin aut Sara Lonardi verfasserin aut Silvia Trapani verfasserin aut Massimo Cardillo verfasserin aut In Cancers MDPI AG, 2010 13(2021), 6, p 1416 (DE-627)614095670 (DE-600)2527080-1 20726694 nnns volume:13 year:2021 number:6, p 1416 https://doi.org/10.3390/cancers13061416 kostenfrei https://doaj.org/article/6c55da21b3104bb4bf45bcc7a1394aa6 kostenfrei https://www.mdpi.com/2072-6694/13/6/1416 kostenfrei https://doaj.org/toc/2072-6694 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 6, p 1416 |
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10.3390/cancers13061416 doi (DE-627)DOAJ054135850 (DE-599)DOAJ6c55da21b3104bb4bf45bcc7a1394aa6 DE-627 ger DE-627 rakwb eng RC254-282 Umberto Cillo verfasserin aut Liver Transplantation for T2 Hepatocellular Carcinoma during the COVID-19 Pandemic: A Novel Model Balancing Individual Benefit against Healthcare Resources 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in liver transplantation for T2 HCC. We proposed a novel ethical framework where the individual transplant benefit for a T2 HCC patient should outweigh the harm to others on the waiting list, determining a “net benefit”, to define appropriate organ allocation. This ethical framework was then translated into a quantitative Markov model including Italian averages for waiting list characteristics, donor resources, mortality, and transplant rates obtained from a national prospective database (n = 8567 patients). The net benefit of transplantation in a T2 HCC patient in a usual situation varied from 0 life months with a model for end-stage liver disease (MELD) score of 15, to 34 life months with a MELD score of 40, while it progressively decreased with acute organ shortage during a pandemic (i.e., with a 50% decrease in organs, the net benefit varied from 0 life months with MELD 30, to 12 life months with MELD 40). Our study supports the continuation of transplantation for T2 HCC patients during crises such as COVID-19; however, the focus needs to be on those T2 HCC patients with the highest net survival benefit. liver transplantation T2 HCC COVID-19 pandemic organ allocation transplant benefit waiting list harm Neoplasms. Tumors. Oncology. Including cancer and carcinogens Alessandro Vitale verfasserin aut Michael L. Volk verfasserin aut Anna Chiara Frigo verfasserin aut Paolo Feltracco verfasserin aut Annamaria Cattelan verfasserin aut Giuseppina Brancaccio verfasserin aut Giuseppe Feltrin verfasserin aut Paolo Angeli verfasserin aut Patrizia Burra verfasserin aut Sara Lonardi verfasserin aut Silvia Trapani verfasserin aut Massimo Cardillo verfasserin aut In Cancers MDPI AG, 2010 13(2021), 6, p 1416 (DE-627)614095670 (DE-600)2527080-1 20726694 nnns volume:13 year:2021 number:6, p 1416 https://doi.org/10.3390/cancers13061416 kostenfrei https://doaj.org/article/6c55da21b3104bb4bf45bcc7a1394aa6 kostenfrei https://www.mdpi.com/2072-6694/13/6/1416 kostenfrei https://doaj.org/toc/2072-6694 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 6, p 1416 |
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10.3390/cancers13061416 doi (DE-627)DOAJ054135850 (DE-599)DOAJ6c55da21b3104bb4bf45bcc7a1394aa6 DE-627 ger DE-627 rakwb eng RC254-282 Umberto Cillo verfasserin aut Liver Transplantation for T2 Hepatocellular Carcinoma during the COVID-19 Pandemic: A Novel Model Balancing Individual Benefit against Healthcare Resources 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in liver transplantation for T2 HCC. We proposed a novel ethical framework where the individual transplant benefit for a T2 HCC patient should outweigh the harm to others on the waiting list, determining a “net benefit”, to define appropriate organ allocation. This ethical framework was then translated into a quantitative Markov model including Italian averages for waiting list characteristics, donor resources, mortality, and transplant rates obtained from a national prospective database (n = 8567 patients). The net benefit of transplantation in a T2 HCC patient in a usual situation varied from 0 life months with a model for end-stage liver disease (MELD) score of 15, to 34 life months with a MELD score of 40, while it progressively decreased with acute organ shortage during a pandemic (i.e., with a 50% decrease in organs, the net benefit varied from 0 life months with MELD 30, to 12 life months with MELD 40). Our study supports the continuation of transplantation for T2 HCC patients during crises such as COVID-19; however, the focus needs to be on those T2 HCC patients with the highest net survival benefit. liver transplantation T2 HCC COVID-19 pandemic organ allocation transplant benefit waiting list harm Neoplasms. Tumors. Oncology. Including cancer and carcinogens Alessandro Vitale verfasserin aut Michael L. Volk verfasserin aut Anna Chiara Frigo verfasserin aut Paolo Feltracco verfasserin aut Annamaria Cattelan verfasserin aut Giuseppina Brancaccio verfasserin aut Giuseppe Feltrin verfasserin aut Paolo Angeli verfasserin aut Patrizia Burra verfasserin aut Sara Lonardi verfasserin aut Silvia Trapani verfasserin aut Massimo Cardillo verfasserin aut In Cancers MDPI AG, 2010 13(2021), 6, p 1416 (DE-627)614095670 (DE-600)2527080-1 20726694 nnns volume:13 year:2021 number:6, p 1416 https://doi.org/10.3390/cancers13061416 kostenfrei https://doaj.org/article/6c55da21b3104bb4bf45bcc7a1394aa6 kostenfrei https://www.mdpi.com/2072-6694/13/6/1416 kostenfrei https://doaj.org/toc/2072-6694 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 6, p 1416 |
allfieldsGer |
10.3390/cancers13061416 doi (DE-627)DOAJ054135850 (DE-599)DOAJ6c55da21b3104bb4bf45bcc7a1394aa6 DE-627 ger DE-627 rakwb eng RC254-282 Umberto Cillo verfasserin aut Liver Transplantation for T2 Hepatocellular Carcinoma during the COVID-19 Pandemic: A Novel Model Balancing Individual Benefit against Healthcare Resources 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in liver transplantation for T2 HCC. We proposed a novel ethical framework where the individual transplant benefit for a T2 HCC patient should outweigh the harm to others on the waiting list, determining a “net benefit”, to define appropriate organ allocation. This ethical framework was then translated into a quantitative Markov model including Italian averages for waiting list characteristics, donor resources, mortality, and transplant rates obtained from a national prospective database (n = 8567 patients). The net benefit of transplantation in a T2 HCC patient in a usual situation varied from 0 life months with a model for end-stage liver disease (MELD) score of 15, to 34 life months with a MELD score of 40, while it progressively decreased with acute organ shortage during a pandemic (i.e., with a 50% decrease in organs, the net benefit varied from 0 life months with MELD 30, to 12 life months with MELD 40). Our study supports the continuation of transplantation for T2 HCC patients during crises such as COVID-19; however, the focus needs to be on those T2 HCC patients with the highest net survival benefit. liver transplantation T2 HCC COVID-19 pandemic organ allocation transplant benefit waiting list harm Neoplasms. Tumors. Oncology. Including cancer and carcinogens Alessandro Vitale verfasserin aut Michael L. Volk verfasserin aut Anna Chiara Frigo verfasserin aut Paolo Feltracco verfasserin aut Annamaria Cattelan verfasserin aut Giuseppina Brancaccio verfasserin aut Giuseppe Feltrin verfasserin aut Paolo Angeli verfasserin aut Patrizia Burra verfasserin aut Sara Lonardi verfasserin aut Silvia Trapani verfasserin aut Massimo Cardillo verfasserin aut In Cancers MDPI AG, 2010 13(2021), 6, p 1416 (DE-627)614095670 (DE-600)2527080-1 20726694 nnns volume:13 year:2021 number:6, p 1416 https://doi.org/10.3390/cancers13061416 kostenfrei https://doaj.org/article/6c55da21b3104bb4bf45bcc7a1394aa6 kostenfrei https://www.mdpi.com/2072-6694/13/6/1416 kostenfrei https://doaj.org/toc/2072-6694 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 6, p 1416 |
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Liver Transplantation for T2 Hepatocellular Carcinoma during the COVID-19 Pandemic: A Novel Model Balancing Individual Benefit against Healthcare Resources |
abstract |
The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in liver transplantation for T2 HCC. We proposed a novel ethical framework where the individual transplant benefit for a T2 HCC patient should outweigh the harm to others on the waiting list, determining a “net benefit”, to define appropriate organ allocation. This ethical framework was then translated into a quantitative Markov model including Italian averages for waiting list characteristics, donor resources, mortality, and transplant rates obtained from a national prospective database (n = 8567 patients). The net benefit of transplantation in a T2 HCC patient in a usual situation varied from 0 life months with a model for end-stage liver disease (MELD) score of 15, to 34 life months with a MELD score of 40, while it progressively decreased with acute organ shortage during a pandemic (i.e., with a 50% decrease in organs, the net benefit varied from 0 life months with MELD 30, to 12 life months with MELD 40). Our study supports the continuation of transplantation for T2 HCC patients during crises such as COVID-19; however, the focus needs to be on those T2 HCC patients with the highest net survival benefit. |
abstractGer |
The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in liver transplantation for T2 HCC. We proposed a novel ethical framework where the individual transplant benefit for a T2 HCC patient should outweigh the harm to others on the waiting list, determining a “net benefit”, to define appropriate organ allocation. This ethical framework was then translated into a quantitative Markov model including Italian averages for waiting list characteristics, donor resources, mortality, and transplant rates obtained from a national prospective database (n = 8567 patients). The net benefit of transplantation in a T2 HCC patient in a usual situation varied from 0 life months with a model for end-stage liver disease (MELD) score of 15, to 34 life months with a MELD score of 40, while it progressively decreased with acute organ shortage during a pandemic (i.e., with a 50% decrease in organs, the net benefit varied from 0 life months with MELD 30, to 12 life months with MELD 40). Our study supports the continuation of transplantation for T2 HCC patients during crises such as COVID-19; however, the focus needs to be on those T2 HCC patients with the highest net survival benefit. |
abstract_unstemmed |
The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in liver transplantation for T2 HCC. We proposed a novel ethical framework where the individual transplant benefit for a T2 HCC patient should outweigh the harm to others on the waiting list, determining a “net benefit”, to define appropriate organ allocation. This ethical framework was then translated into a quantitative Markov model including Italian averages for waiting list characteristics, donor resources, mortality, and transplant rates obtained from a national prospective database (n = 8567 patients). The net benefit of transplantation in a T2 HCC patient in a usual situation varied from 0 life months with a model for end-stage liver disease (MELD) score of 15, to 34 life months with a MELD score of 40, while it progressively decreased with acute organ shortage during a pandemic (i.e., with a 50% decrease in organs, the net benefit varied from 0 life months with MELD 30, to 12 life months with MELD 40). Our study supports the continuation of transplantation for T2 HCC patients during crises such as COVID-19; however, the focus needs to be on those T2 HCC patients with the highest net survival benefit. |
collection_details |
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container_issue |
6, p 1416 |
title_short |
Liver Transplantation for T2 Hepatocellular Carcinoma during the COVID-19 Pandemic: A Novel Model Balancing Individual Benefit against Healthcare Resources |
url |
https://doi.org/10.3390/cancers13061416 https://doaj.org/article/6c55da21b3104bb4bf45bcc7a1394aa6 https://www.mdpi.com/2072-6694/13/6/1416 https://doaj.org/toc/2072-6694 |
remote_bool |
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author2 |
Alessandro Vitale Michael L. Volk Anna Chiara Frigo Paolo Feltracco Annamaria Cattelan Giuseppina Brancaccio Giuseppe Feltrin Paolo Angeli Patrizia Burra Sara Lonardi Silvia Trapani Massimo Cardillo |
author2Str |
Alessandro Vitale Michael L. Volk Anna Chiara Frigo Paolo Feltracco Annamaria Cattelan Giuseppina Brancaccio Giuseppe Feltrin Paolo Angeli Patrizia Burra Sara Lonardi Silvia Trapani Massimo Cardillo |
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doi_str |
10.3390/cancers13061416 |
callnumber-a |
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up_date |
2024-07-03T21:31:24.141Z |
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