2023
Honoring the gift: The transformative potential of transplant-declined human organs
Albert C, Harris M, DiRito J, Shi A, Edwards C, Harkins L, Lysyy T, Kulkarni S, Mulligan D, Hosgood S, Watson C, Friend P, Nicholson M, Haakinson D, Saeb-Parsy K, Tietjen G. Honoring the gift: The transformative potential of transplant-declined human organs. American Journal Of Transplantation 2023, 23: 165-170. PMID: 36695696, DOI: 10.1016/j.ajt.2022.11.015.Peer-Reviewed Original Research
2021
Inactive status is an independent predictor of liver transplant waitlist mortality and is associated with a transplant centers median meld at transplant
Merola J, Gan G, Stewart D, Noreen S, Mulligan D, Batra R, Haakinson D, Deng Y, Kulkarni S. Inactive status is an independent predictor of liver transplant waitlist mortality and is associated with a transplant centers median meld at transplant. PLOS ONE 2021, 16: e0260000. PMID: 34793524, PMCID: PMC8601542, DOI: 10.1371/journal.pone.0260000.Peer-Reviewed Original ResearchConceptsDonor service areasWaitlist mortalityTransplant centersMedian MELDHigh mortalityStatus changesLiver transplant waitlist mortalityDeceased donor transplantsInactive statusTransplant probabilityInactive patientsMELD scoreDonor transplantsHazard ratioIndependent predictorsTransplant ratesCare coordinationMortalityPatientsTransplantLevel cohortsTertileSignificant differencesCohortMELDChanges in Use of Left Ventricular Assist Devices as Bridge to Transplantation With New Heart Allocation Policy
Mullan CW, Chouairi F, Sen S, Mori M, Clark KAA, Reinhardt SW, Miller PE, Fuery MA, Jacoby D, Maulion C, Anwer M, Geirsson A, Mulligan D, Formica R, Rogers JG, Desai NR, Ahmad T. Changes in Use of Left Ventricular Assist Devices as Bridge to Transplantation With New Heart Allocation Policy. JACC Heart Failure 2021, 9: 420-429. PMID: 33714748, DOI: 10.1016/j.jchf.2021.01.010.Peer-Reviewed Original ResearchConceptsDonor heart allocation systemNumber of patientsHeart allocation systemVentricular assist deviceWaitlist survivalAssist deviceNew heart allocation policyLeft ventricular assist deviceAllocation system changePost-transplant mortalityOrgan Sharing databaseOutcomes of patientsPost-transplantation outcomesProportion of patientsTime of transplantContinuous-flow LVADPost-transplantation survivalHeart allocation policyNew allocation systemBaseline recipientStatus 1AHeart transplantationIschemic timeLVAD implantationTransplant list
2019
Frequency of whole-organ in lieu of split-liver transplantation over the last decade: Children experienced increased wait time and death
Valentino PL, Emre S, Geliang G, Li L, Deng Y, Mulligan D, Rodriguez-Davalos M. Frequency of whole-organ in lieu of split-liver transplantation over the last decade: Children experienced increased wait time and death. American Journal Of Transplantation 2019, 19: 3114-3123. PMID: 31152483, DOI: 10.1111/ajt.15481.Peer-Reviewed Original ResearchConceptsAdult recipientsTransplantation Network/United NetworkNumber of allograftsOrgan Sharing dataSplit-liver transplantationCareful patient selectionDeceased donor liversNumber of LTLT graftSLT recipientsUnderwent LTWLT recipientsPediatric candidatesPatient selectionDonor liversOrgan utilizationUnited NetworkOrgan shortageOrgan procurementSmall childrenRecipientsTransplantation
2017
Predictors of Waitlist Mortality in Portopulmonary Hypertension
DuBrock HM, Goldberg DS, Sussman NL, Bartolome SD, Kadry Z, Salgia RJ, Mulligan DC, Kremers WK, Kawut SM, Krowka MJ, Channick RN. Predictors of Waitlist Mortality in Portopulmonary Hypertension. Transplantation 2017, 101: 1609-1615. PMID: 28207639, PMCID: PMC5481480, DOI: 10.1097/tp.0000000000001666.Peer-Reviewed Original ResearchMeSH KeywordsArterial PressureCause of DeathChi-Square DistributionDatabases, FactualDecision Support TechniquesFemaleHumansHypertension, PortalHypertension, PulmonaryKaplan-Meier EstimateLiver DiseasesLiver TransplantationMaleMiddle AgedMultivariate AnalysisPortal PressurePredictive Value of TestsProportional Hazards ModelsPulmonary ArteryPulmonary CirculationRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsTissue and Organ ProcurementTreatment OutcomeVascular ResistanceWaiting ListsConceptsPortopulmonary hypertensionWaitlist mortalityMELD exceptionsLiver diseaseException scoreEnd-Stage Liver Disease (MELD) exception pointsSignificant predictorsCox proportional hazards modelMELD exception scoreWaitlist mortality riskRetrospective cohort studyPulmonary arterial pressureTransplantation Network databaseSignificant univariate predictorsOnly significant univariate predictorsProportional hazards modelMELD scorePosttransplant mortalityPulmonary hypertensionCohort studyArterial pressureUnivariate predictorsC-statisticMortality riskHazards modelInequity in organ allocation for patients awaiting liver transplantation: Rationale for uncapping the model for end-stage liver disease
Nadim MK, DiNorcia J, Ji L, Groshen S, Levitsky J, Sung RS, Kim WR, Andreoni K, Mulligan D, Genyk YS. Inequity in organ allocation for patients awaiting liver transplantation: Rationale for uncapping the model for end-stage liver disease. Journal Of Hepatology 2017, 67: 517-525. PMID: 28483678, PMCID: PMC7735955, DOI: 10.1016/j.jhep.2017.04.022.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseLiver transplantMELD scoreLiver diseaseSick patientsLiver transplantationOrgan allocationEquitable organ distributionGreater MELD scoresPost-transplant outcomesOrgan Sharing dataPost-transplant survivalUnderwent liver transplantObjective scoring systemWaitlist registrationWaitlist mortalityHazard ratioSurvival benefitWaitlist candidatesUnited NetworkPatientsTransplantScoring systemMELDOrgan distributionLiver allocation and distribution
Deshpande R, Hirose R, Mulligan D. Liver allocation and distribution. Current Opinion In Organ Transplantation 2017, 22: 162-168. PMID: 28212159, DOI: 10.1097/mot.0000000000000397.Peer-Reviewed Original ResearchConceptsTransplant CommitteeTransplant centersEnd-Stage Liver Disease (MELD) pointsLiver allograft allocationDeceased donor liversLife-saving organsLiver allocation policyAllograft allocationLiver transplantLiver transplantationLiver diseaseDonor liversUnited NetworkDonor organsLiver distributionAdvanced stageLiver allocationOrgan distributionPatient accessTransplantationGeographic disparitiesLiverDisease pointHealthcare systemPatients
2016
Predicting Outcomes on the Liver Transplant Waiting List in the United States
Hart A, Schladt DP, Zeglin J, Pyke J, Kim WR, Lake JR, Roberts JP, Hirose R, Mulligan DC, Kasiske BL, Snyder JJ, Israni AK. Predicting Outcomes on the Liver Transplant Waiting List in the United States. Transplantation 2016, 100: 2153-2159. PMID: 27490411, PMCID: PMC5369025, DOI: 10.1097/tp.0000000000001384.Peer-Reviewed Original ResearchConceptsDonation service areaLiver transplantWaiting listEnd-stage liver disease (MELD) scoreLiver transplant waiting listTransplant Recipients databaseLiver Disease scoreMELD exception pointsTransplant waiting listAvailability of organsTransplant probabilityRecipients databasePatient characteristicsScientific RegistryTransplant programsUS adultsDisease scorePredicting OutcomeException pointsTransplantBlood typeOutcomesOngoing disparitiesCorresponding percentilesOnline calculatorAttitudes toward organ donation among waitlisted transplant patients: results of a cross‐sectional survey
Merola J, Pei K, Rodriguez‐Davalos M, Gan G, Deng Y, Mulligan DC, Davis KA. Attitudes toward organ donation among waitlisted transplant patients: results of a cross‐sectional survey. Clinical Transplantation 2016, 30: 1449-1456. PMID: 27582432, PMCID: PMC5093046, DOI: 10.1111/ctr.12839.Peer-Reviewed Original ResearchConceptsCross-sectional surveyOrgan donationWaitlisted candidatesMinority of patientsDonor registration ratesDonation eligibilityTransplant patientsWaitlisted patientsPatients' willingnessGeneral populationOrgan donorsOrgan shortageMedical treatmentPatientsOrgan allocationDonation ratesTransplantationRegistration ratesDonationMajor barrierPopulationDonorsWaitlistPhysiciansDemographicsThe impact of broader regional sharing of livers: 2‐year results of “Share 35”
Edwards EB, Harper AM, Hirose R, Mulligan DC. The impact of broader regional sharing of livers: 2‐year results of “Share 35”. Liver Transplantation 2016, 22: 399-409. PMID: 26890858, DOI: 10.1002/lt.24418.Peer-Reviewed Original ResearchConceptsWaiting list mortalityLiver transplantLiver diseaseEnd-stage liver disease candidatesEnd-stage liver diseasePosttransplant survival outcomesChronic liver diseaseCold ischemia timeShare 35 policyRegional sharingBroader regional sharingPost-policy periodPosttransplant graftUrgent groupIschemia timePatient survivalSurvival outcomesMedian MELDMortality rateSickest candidatesOrgan procurementTransplantation NetworkTransplantAge groupsUrgent patientsSimultaneous Liver–Kidney Allocation Policy: A Proposal to Optimize Appropriate Utilization of Scarce Resources
Formica R, Aeder M, Boyle G, Kucheryavaya A, Stewart D, Hirose R, Mulligan D. Simultaneous Liver–Kidney Allocation Policy: A Proposal to Optimize Appropriate Utilization of Scarce Resources. American Journal Of Transplantation 2016, 16: 758-766. PMID: 26603142, DOI: 10.1111/ajt.13631.Peer-Reviewed Original ResearchConceptsMayo End-Stage Liver Disease (MELD) scoreEnd-stage liver disease (MELD) scoreSimultaneous liver-kidney transplantKidney Donor Profile IndexConcurrent kidney transplantsLiver-kidney transplantLiver Disease scoreMedical Eligibility CriteriaLiver allocation policyOPTN Final RulePediatric recipientsKidney transplantRenal functionRenal insufficiencyUnited NetworkLiver candidatesTransplant communityDisease scoreOrgan donorsEligibility criteriaOrgan procurementTransplantation NetworkFinal ruleKidney allocationYoung adults
2015
Disparity, Liver Demand, and Access to Transplants
Mulligan D. Disparity, Liver Demand, and Access to Transplants. American Journal Of Transplantation 2015, 15: 1746-1747. PMID: 25929170, DOI: 10.1111/ajt.13302.Peer-Reviewed Original ResearchEarly Changes in Liver Distribution Following Implementation of Share 35
Massie AB, Chow EK, Wickliffe CE, Luo X, Gentry SE, Mulligan DC, Segev DL. Early Changes in Liver Distribution Following Implementation of Share 35. American Journal Of Transplantation 2015, 15: 659-667. PMID: 25693474, PMCID: PMC6116537, DOI: 10.1111/ajt.13099.Peer-Reviewed Original ResearchConceptsDeceased donor liver transplantBaseline MELDShare 35Waitlist mortalityLiver distributionEarly posttransplant outcomesLower waitlist mortalityOdds of discardHandful of centersPosttransplant lengthLiver transplantPosttransplant mortalityPosttransplant outcomesEquivalent time periodMore transplantsEarly changesMELDMortalityPatientsTransplantMonthsEvidence of changesLiver allocation: Can we ever get it right and should we ever get it right?
Neuberger J, Mulligan D. Liver allocation: Can we ever get it right and should we ever get it right? Hepatology 2015, 61: 28-31. PMID: 25130673, DOI: 10.1002/hep.27359.Peer-Reviewed Original Research
2006
Reduced Priority MELD Score for Hepatocellular Carcinoma Does Not Adversely Impact Candidate Survival Awaiting Liver Transplantation
Sharma P, Harper AM, Hernandez JL, Heffron T, Mulligan DC, Wiesner RH, Balan V. Reduced Priority MELD Score for Hepatocellular Carcinoma Does Not Adversely Impact Candidate Survival Awaiting Liver Transplantation. American Journal Of Transplantation 2006, 6: 1957-1962. PMID: 16771808, DOI: 10.1111/j.1600-6143.2006.01411.x.Peer-Reviewed Original ResearchConceptsDeceased donor liver transplantationHepatocellular carcinomaHCC candidatesCandidate survivalLiver transplantationMELD scoreStage T1Waiting listEnd-stage liver diseaseDonor liver transplantationT2 hepatocellular carcinomaOrgan allocation policyUNOS databaseLiver transplantLiver diseasePatient survivalUnited NetworkHCC patientsIncidence rateOrgan SharingSurvivalTransplantationCarcinomaDropout rateTime periodLiver Transplantation in the MELD Era: A Single-Center Experience
Sachdev M, Hernandez JL, Sharma P, Douglas DD, Byrne T, Harrison ME, Mulligan D, Moss A, Reddy K, Vargas HE, Rakela J, Balan V. Liver Transplantation in the MELD Era: A Single-Center Experience. Digestive Diseases And Sciences 2006, 51: 1070-1078. PMID: 16865573, DOI: 10.1007/s10620-006-8011-1.Peer-Reviewed Original ResearchMeSH KeywordsArizonaCarcinoma, HepatocellularFemaleHepatitis CHumansLiver DiseasesLiver NeoplasmsLiver TransplantationMaleMedical RecordsMiddle AgedOutcome Assessment, Health CareResource AllocationRetrospective StudiesRisk AssessmentSeverity of Illness IndexSurvival AnalysisTissue and Organ ProcurementWaiting ListsConceptsDeceased donor liver transplantationLiver transplantationTransplantation ratesEndstage Liver Disease (MELD) scoreImpact of MELDDonor liver transplantationLiver Disease scoreUnderlying liver diseaseSingle-center experienceHepatocellular carcinoma patientsHepatitis C virusNew allocation policyHCC candidatesMELD implementationNew MELDTimely transplantClinical deteriorationMELD eraCarcinoma patientsLiver diseaseHepatitis C virus groupC virusHCC patientsMayo ClinicDropout rate
2005
Regional Variations in Peer Reviewed Liver Allocation Under the MELD System
Rodriguez‐Luna H, Vargas HE, Moss A, Reddy KS, Freeman RB, Mulligan D. Regional Variations in Peer Reviewed Liver Allocation Under the MELD System. American Journal Of Transplantation 2005, 5: 2244-2247. PMID: 16095504, DOI: 10.1111/j.1600-6143.2005.01008.x.Peer-Reviewed Original Research
2004
Liver transplantation for hepatocellular cancer: The impact of the MELD allocation policy
Wiesner RH, Freeman RB, Mulligan DC. Liver transplantation for hepatocellular cancer: The impact of the MELD allocation policy. Gastroenterology 2004, 127: s261-s267. PMID: 15508092, DOI: 10.1053/j.gastro.2004.09.040.Peer-Reviewed Original ResearchConceptsNumber of patientsHepatocellular cancerHCC patientsWaiting listLiver transplantationDeceased donorsExcellent long-term survivalPost-MELD eraAdvanced stage diseaseLiver transplant candidatesLong-term survivalHigh mortality rateProgression of HCCHCC recipientsPosttransplant survivalStage diseaseTransplant candidatesUnited NetworkDonor organsLower incidenceMortality ratePatientsAdvanced stageEarly assessmentTransplantationLiver transplantation for hepatocellular carcinoma: The MELD impact
Sharma P, Balan V, Hernandez JL, Harper AM, Edwards EB, Rodriguez‐Luna H, Byrne T, Vargas HE, Mulligan D, Rakela J, Wiesner RH. Liver transplantation for hepatocellular carcinoma: The MELD impact. Liver Transplantation 2004, 10: 36-41. PMID: 14755775, DOI: 10.1002/lt.20012.Peer-Reviewed Original ResearchConceptsDeceased donor liver transplantationNew allocation policyHCC candidatesPerson yearsIncidence rateHepatocellular carcinomaLiver transplantationUNOS databaseEnd-stage liver diseaseT2 hepatocellular carcinomaDonor liver transplantationDropout rateDate of implementationHepatic decompensationNew MELDClinical deteriorationMELD scoreLiver diseaseStage T1United NetworkOrgan SharingWaiting listSurvivalTransplantationCarcinoma
2003
Recent Advances in Liver Transplantation
Wiesner RH, Rakela J, Ishitani MB, Mulligan DC, Spivey JR, Steers JL, Krom RA. Recent Advances in Liver Transplantation. Mayo Clinic Proceedings 2003, 78: 197-210. PMID: 12583530, DOI: 10.4065/78.2.197.Peer-Reviewed Original ResearchConceptsLiver transplantationHepatitis CEnd-stage liver disease (MELD) allocation systemRecurrent hepatitis C.Acute cellular rejectionDonor liver transplantationRecurrent hepatitis CDeath of patientsLong-term survivalLiver allocation policyQuality of lifeCellular rejectionChronic rejectionDomino transplantationImmunosuppressive regimensMetabolic complicationsRecurrent diseaseHepatitis C.Marginal donorsProlong survivalUnited NetworkHepatic support systemDonor poolEffective therapyDonor organs