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Liver transplantation in the MELD era: a single-center experience.
Dig Dis Sci. 2006 Jun; 51(6):1070-8.DD

Abstract

Model for Endstage Liver Disease (MELD) score has been used to allocate organs since February 2002. This policy allocates organs to candidates with regard to severity of their underlying liver disease except in the case of hepatocellular carcinoma (HCC) patients. The purpose of this study was to determine the impact of MELD on waiting times, dropout rates, and transplantation rates in all patients awaiting liver transplantation at our center. The records of all patients listed for liver transplantation between May 28, 1999, and February 27, 2004, at the Mayo Clinic, Scottsdale, Arizona, were reviewed. Candidates were grouped by two time periods as pre-MELD or post-MELD based on date of MELD implementation (February 27, 2002). The incidence of deceased donor liver transplantation (DDLT), waiting time to DDLT, dropout rate from the waiting list because of clinical deterioration or death, and survival while waiting for or after DDLT were determined for each group. Three hundred fifty-one patients were listed for liver transplantation (195 pre-MELD, 156 post-MELD) during the study period. HCC patients had an improved rate of transplantation after MELD (pre-MELD, 1.39 persons per year; post-MELD, 3.48 persons per year). In all groups, with the exception of hepatitis C virus, the transplantation rates were the same for both categories. The hepatitis C virus group also had improved transplantation rates in the post-MELD period. HCC candidates under the new allocation policy have an increased incidence of DDLT in our institution. However, this has not disadvantaged patients with non-HCC diagnoses. Thus, the new MELD-based allocation policy has benefited all candidates by allowing more timely transplants.

Authors+Show Affiliations

Division of Transplantation Medicine, Mayo Clinic, Scottsdale, Arizona, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16865573

Citation

Sachdev, Mankanwal, et al. "Liver Transplantation in the MELD Era: a Single-center Experience." Digestive Diseases and Sciences, vol. 51, no. 6, 2006, pp. 1070-8.
Sachdev M, Hernandez JL, Sharma P, et al. Liver transplantation in the MELD era: a single-center experience. Dig Dis Sci. 2006;51(6):1070-8.
Sachdev, M., Hernandez, J. L., Sharma, P., Douglas, D. D., Byrne, T., Harrison, M. E., Mulligan, D., Moss, A., Reddy, K., Vargas, H. E., Rakela, J., & Balan, V. (2006). Liver transplantation in the MELD era: a single-center experience. Digestive Diseases and Sciences, 51(6), 1070-8.
Sachdev M, et al. Liver Transplantation in the MELD Era: a Single-center Experience. Dig Dis Sci. 2006;51(6):1070-8. PubMed PMID: 16865573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Liver transplantation in the MELD era: a single-center experience. AU - Sachdev,Mankanwal, AU - Hernandez,Jose L, AU - Sharma,Pratima, AU - Douglas,David D, AU - Byrne,Thomas, AU - Harrison,M Edwyn, AU - Mulligan,David, AU - Moss,Adyr, AU - Reddy,Kunam, AU - Vargas,Hugo E, AU - Rakela,Jorge, AU - Balan,Vijayan, PY - 2005/03/02/received PY - 2005/03/21/accepted PY - 2006/7/26/pubmed PY - 2006/8/31/medline PY - 2006/7/26/entrez SP - 1070 EP - 8 JF - Digestive diseases and sciences JO - Dig Dis Sci VL - 51 IS - 6 N2 - Model for Endstage Liver Disease (MELD) score has been used to allocate organs since February 2002. This policy allocates organs to candidates with regard to severity of their underlying liver disease except in the case of hepatocellular carcinoma (HCC) patients. The purpose of this study was to determine the impact of MELD on waiting times, dropout rates, and transplantation rates in all patients awaiting liver transplantation at our center. The records of all patients listed for liver transplantation between May 28, 1999, and February 27, 2004, at the Mayo Clinic, Scottsdale, Arizona, were reviewed. Candidates were grouped by two time periods as pre-MELD or post-MELD based on date of MELD implementation (February 27, 2002). The incidence of deceased donor liver transplantation (DDLT), waiting time to DDLT, dropout rate from the waiting list because of clinical deterioration or death, and survival while waiting for or after DDLT were determined for each group. Three hundred fifty-one patients were listed for liver transplantation (195 pre-MELD, 156 post-MELD) during the study period. HCC patients had an improved rate of transplantation after MELD (pre-MELD, 1.39 persons per year; post-MELD, 3.48 persons per year). In all groups, with the exception of hepatitis C virus, the transplantation rates were the same for both categories. The hepatitis C virus group also had improved transplantation rates in the post-MELD period. HCC candidates under the new allocation policy have an increased incidence of DDLT in our institution. However, this has not disadvantaged patients with non-HCC diagnoses. Thus, the new MELD-based allocation policy has benefited all candidates by allowing more timely transplants. SN - 0163-2116 UR - https://www.unboundmedicine.com/medline/citation/16865573/Liver_transplantation_in_the_MELD_era:_a_single_center_experience_ L2 - https://doi.org/10.1007/s10620-006-8011-1 DB - PRIME DP - Unbound Medicine ER -