The amount of time the least sick patients wait for a donor liver does not affect one-year survival for most patients, according to a study by the United Network for Organ Sharing (UNOS).
The study also shows that the chance that a status 3 patient (a patient with the least medical urgency for a new liver) will die while waiting for a liver is not significantly affected by how long the patient is on the list.
"This study is important because it proves that long waiting times for most status 3 patients does not put them at a disadvantage," said Steven L. Flamm, MD, one of four authors of the study and a liver transplant physician at Northwestern Memorial Hospital in Chicago. "This study suggests that equalizing waiting time should not be a high priority."
Results of the study were released on June 22. Three days later, the board of directors of UNOS approved a plan that would give less priority to status 3 patients waiting for donor livers. Traditionally, status 3 patients became eligible for livers if status 1 and status 2 patients in a local area did not need the organs. With the new plan, livers will be offered first to the sickest patients within a much broader geographical region before being offered to status 3 patients. (See New Liver Distribution Policy Favors Sickest Patients within a Region in today's Transplant News Network.)
The authors of the study examined 1,764 liver patients with ascites and encephalopathy who were put on the waiting list as status 3 and who received a transplant between April 1, 1994, and March 31, 1997. While waiting time played virtually no role in one-year survival, it influenced one- and three-month survival for only a "small fraction of the patients," UNOS said.
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