About: An international multicentre study of protocols for liver transplantation during a pandemic: A case for quadripartite equipoise

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About: An international multicentre study of protocols for liver transplantation during a pandemic: A case for quadripartite equipoise Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	An international multicentre study of protocols for liver transplantation during a pandemic: A case for quadripartite equipoise
Creator	Wang, Chih-Chi Bonney, Glenn Kim, Jong Wang, Ch, M Reddy, Angelico, Roberta Muiesan, Paolo Reddy, Srinivas Derosas, Carlos Pitchaimuthu, Maheswaran Scalera, Irene Isaac, John Mirza, Darius Halazun, Karim Aw, Kow Battula, Narendra Bm, Buchholz Buchholz, Bettina Chan, Chi-Yan Chew, Claire Derosas, Dip, A Farid, Sharid Hons, Ganpathi Imventarza, Imventarza, Oscar Iyer, F Iyer, Shridhar Jm, Kim Kj, Halazun Kow, Chieh Kunnath Bonney, F Kunnath Bonney, Glenn Madhavan, Krishnakumar Mirza, F Part, A Pitchaimuthu, F Rotellar, Fernando Soin, F Soin, Singh Sze, Andrea Wei, Alfred Wong, Teng
Source	Elsevier; Medline; PMC
abstract	BACKGROUND: The outbreak of Covid-19 has vastly increased the operational burden on healthcare systems worldwide. For patients with end-stage liver failure, liver transplantation is the only option. However, the strain on intensive care facilities caused by the pandemic is a major concern. There is an urgent need for ethical frameworks to balance the need for liver transplantation against the availability of national resources. METHODS: We performed an international multi-center study of transplant centers to understand the evolution of policies for transplant prioritization in response to the pandemic in March 2020. To describe the ethical tension arising in this setting, we propose a novel ethical framework, the Quadripartite Equipoise (QE) score, that is applicable to liver transplantation in the context of limited national resources. RESULTS: Seventeen large- and medium- sized liver transplant centers from twelve countries across four continents participated. Ten centers opted to limit transplant activity in response to the pandemic, favoring a “sickest-first” approach. Conversely, some larger centers opted to continue routine transplant activity in order to balance waiting list mortality. To model these and other ethical tensions, we computed a QE score using 4 factors - Recipient Outcome, Donor/Graft Safety, Waiting List Mortality and Healthcare Resources for seven countries. The fluctuation of the QE score over time accurately reflects the dynamic changes in the ethical tensions surrounding transplant activity in a pandemic. CONCLUSIONS: This four-dimensional model of Quadripartite Equipoise addresses the ethical tensions in the current pandemic. It serves as a universally applicable framework to guide regulation of transplant activity in response to the increasing burden on healthcare systems to allow greater global solidarity and transparency in these austere times.
has issue date	2020-05-23(xsd:dateTime)
bibo:doi	10.1016/j.jhep.2020.05.023
bibo:pmid	32454041
has license	no-cc
sha1sum (hex)	df71d4bf0c0b0ae9d9a3ea6c04596338755203db
schema:url	https://doi.org/10.1016/j.jhep.2020.05.023
resource representing a document's title	An international multicentre study of protocols for liver transplantation during a pandemic: A case for quadripartite equipoise
has PubMed Central identifier	PMC7245234
has PubMed identifier	32454041
schema:publication	J Hepatol
resource representing a document's body	covid:df71d4bf0c0b0ae9d9a3ea6c04596338755203db#body_text
is schema:about of	named entity 'pandemic' named entity 'intensive care' named entity 'Liver Disease' named entity 'Seattle' named entity 'Italy' named entity 'ICU beds' named entity 'Covid' named entity 'respiratory compromise' named entity 'ICU' named entity 'intensive care' named entity 'kidney transplantation' named entity 'CDC' named entity 'Covid-19 pandemic' named entity 'healthcare systems' named entity 'ethical considerations' named entity 'Centers for Disease Control and Prevention' named entity 'hemodialysis' named entity 'liver transplantation' named entity '11.6' named entity 'liver transplantation' named entity 'coronavirus disease 2019' named entity 'healthcare systems' named entity 'viral pandemic' named entity 'organ transplantation' named entity 'health services' named entity 'shared resource' named entity 'Covid' named entity 'March 2020' named entity 'Wuhan' named entity 'liver failure' named entity 'medical treatment' named entity 'viral pandemic' named entity 'centroid' named entity 'healthcare workers' named entity 'liver transplantation' named entity 'ICU' named entity 'ICUs' named entity 'national resources'

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