Frequency of and reasons behind non-listing in adult patients referred for liver transplantation: Results from a retrospective study

Table 3 Reasons behind non-listing for liver transplantation

Non-listing categories	Non-listing motivations	N°
Contraindications	Psychological1	19	9.3%	91	44.4%
	Cardiovascular2	14	6.8%
	Surgical3	12	5.9%
	Ongoing alcohol abuse4	10	4.9%
	Infectious5	10	4.9%
	Obesity (BMI > 35)	9	4.4%
	Respiratory6	7	3.4%
	Extrahepatic malignancy7	6	2.9%
	Malnutrition8	4	1.9%
Incorrect indication	MELD Na < 159	33	16.1%	76	37.1%
	Recovery after conservative management for confirmed or suspected ALF	21	10.2%
	HCC beyond up-to-7 criteria and not amenable to downstaging	16	7.8%
	Low Mayo Risk Score	4	2.0%
	HCC successfully treated (T0)	2	1.0%
Patient decision	Refused transplantation	16	7.8%	25	12.2%
	Chose another center	6	2.9%
	Lost to follow-up	3	1.5%
Complications during evaluation		13	6.3%	13	6.3%
Total		205	100%	205	100%

¹6 cases of psychiatric comorbidities, 5 cases of neurological comorbidities, 3 cases of persistent non-compliance, 5 cases of the lack of an adequate support system.

²8 cases of ischemic heart disease, 4 cases of valvular heart disease, 1 case of arrhythmia, 1 case of pulmonary hypertension.

³5 cases of portal vein thrombosis Yerdel III-IV, 6 cases of previous gastrointestinal surgery with arterial axil alteration, 1 case of high-risk re-transplantation.

⁴abstinence period < 6 months and negative evaluation by alcohol-disorders specialist.

⁵4 cases of pneumonia, 2 cases of sepsis, 2 cases of HIV infection, 1 case of active tuberculosis, 1 case of osteomyelitis.

⁶5 cases of severe chronic obstructive pulmonary disease, 1 case of severe restrictive pattern, 1 case of interstitial lung disease.

⁷2 cases of breast cancer, 1 case of ovarian cancer, 1 case of lung cancer, 1 case of pancreatic cancer, 1 case of lymphoma.

⁸Based on the opinions of the nutritional consultant and the subsequent multidisciplinary (transplant hepatologist, transplant surgeon, and anesthesist) decision.

⁹After the antiviral treatment or alcoholic abstinence.

MELD-Na: Model for end-stage liver disease-sodium; ALF: Acute liver failure; HCC: Hepatocellular carcinoma; BMI: Body mass index.