Year 2024 / Volume 116 / Number 12
Special Article
First consensus document of waiting list prioritization for liver transplantation by the Spanish Society of Liver Transplantation (SETH)

680-689

DOI: 10.17235/reed.2024.10639/2024

Itxarone Bilbao, Laura Lladó, Alba Cachero, Isabel Campos-Varela, Jordi Colmenero, Javier del Hoyo, Emilio Fábrega García, Félix García-Pajares, Luisa González Diéguez, Rocío González Grande, Ana Guiberteau Sánchez, Francisco Hernández Oliveros, José Ignacio Herrero Santos, Sara Lorente, Rosa Martín Mateos, María José Mesa López, José Luis Montero Álvarez, Carolina Muñoz Codoceo, Alejandra Otero Ferreiro, Elena Otón Nieto, María Rodríguez Soler, Mario Romero Cristóbal, Lidia Sastre Oliver, María Senosiain Labiano, José Manuel Sousa Martín, María Trapero-Marugán, Evaristo Varo, Gloria de la Rosa, Manuel Rodríguez-Perálvarez,

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.
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16/12/2024 23:20:22
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Citation tools
Bilbao I, Lladó L, Cachero A, Campos-Varela I, Colmenero J, del Hoyo J, et all. First consensus document of waiting list prioritization for liver transplantation by the Spanish Society of Liver Transplantation (SETH). 10639/2024


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Publication history

Received: 08/07/2024

Accepted: 18/07/2024

Online First: 13/09/2024

Published: 13/12/2024

Article Online First time: 67 days

Article editing time: 158 days


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