Transplant Patients Want a Role in Liver Quality Decisions

Patients want organs with low risk of failure, but risk tolerance influenced by presentation

TUESDAY, Dec. 6 (HealthDay News) -- Patients waiting for liver transplantation want to be involved in decisions about organ quality, and the level of risk they are prepared to tolerate is influenced by the presentation format, according to a study published in the December issue of Liver Transplantation.

Michael L. Volk, M.D., from the University of Michigan in Ann Arbor, and colleagues investigated how candidates for liver transplantation think about organ quality. Initially, 10 patients on the waiting list were interviewed, and then 95 patients completed a computerized survey to determine the risk of graft failure that patients would accept.

The investigators found that the first 10 patients interviewed had limited understanding about the range of organ quality and were hesitant to consider anything but the best organs. Of the patients who completed the survey, 58 percent said they would accept only organs with a risk of graft failure at three years of 25 percent or less, with 18 percent wanting to accept only organs with the lowest risk possible. When the organ quality was explained comparative to average organs instead of the best organs, and when feedback was given about the consequences for organ availability, risk tolerance increased. Men were inclined to favor lower risk organs as compared to women (mean acceptable risk, 29 versus 35 percent), but other demographic and clinical characteristics did not impact risk tolerance. Over three-quarters of the patients stated that they wanted to have an equal or dominant role in decisions regarding organ acceptance.

"Our patients expressed a strong desire to be involved in decisions about organ quality and demonstrated widely varying levels of risk tolerance," the authors write.

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