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Change in model for end-stage liver disease score on the transplant waiting list predicts survival in patients undergoing liver transplantation.
Transpl Int. 2006 Dec; 19(12):988-94.TI

Abstract

Allocation of donor livers through the model for end-stage liver disease (MELD) score has resulted in a fall in waiting list deaths in the United States. Change in MELD score (DeltaMELD) whilst awaiting transplant has been suggested as a method of refining organ allocation. Our aims were to analyse the effect of DeltaMELD between listing and transplant, and examine its impact on patient survival, intensive care stay and hospital stay in 402 patients transplanted for chronic liver disease at a single centre. Patients who had a DeltaMELD score of >+1 point were more likely to die in hospital following transplant (P < 0.05) and had a significantly worse 12- and 36-month survival post transplant (P < 0.0001) when compared with patients with DeltaMELD <or=+1 (77.8% vs. 91.9% at 12 months; 72.1% vs. 83.6% at 36 months). This difference persisted even when in-hospital deaths were excluded (P = 0.0148). In a Cox-proportional hazards model, factors associated with reduced survival were DeltaMELD (P = 0.008), and transplant from intensive care (P < 0.001). In conclusion, change in MELD score whilst on the transplant waiting list has a significant effect on survival post-transplant although MELD score at the time of transplant appears to have the most significant effect on resource utilization.

Authors+Show Affiliations

Institute of Liver Studies, Kings' College Hospital, London, UK.No 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

17081228

Citation

Foxton, Matthew R., et al. "Change in Model for End-stage Liver Disease Score On the Transplant Waiting List Predicts Survival in Patients Undergoing Liver Transplantation." Transplant International : Official Journal of the European Society for Organ Transplantation, vol. 19, no. 12, 2006, pp. 988-94.
Foxton MR, Kendrick S, Sizer E, et al. Change in model for end-stage liver disease score on the transplant waiting list predicts survival in patients undergoing liver transplantation. Transpl Int. 2006;19(12):988-94.
Foxton, M. R., Kendrick, S., Sizer, E., Muiesan, P., Rela, M., Wendon, J., Heaton, N. D., O'Grady, J. G., & Heneghan, M. A. (2006). Change in model for end-stage liver disease score on the transplant waiting list predicts survival in patients undergoing liver transplantation. Transplant International : Official Journal of the European Society for Organ Transplantation, 19(12), 988-94.
Foxton MR, et al. Change in Model for End-stage Liver Disease Score On the Transplant Waiting List Predicts Survival in Patients Undergoing Liver Transplantation. Transpl Int. 2006;19(12):988-94. PubMed PMID: 17081228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Change in model for end-stage liver disease score on the transplant waiting list predicts survival in patients undergoing liver transplantation. AU - Foxton,Matthew R, AU - Kendrick,Stewart, AU - Sizer,Elizabeth, AU - Muiesan,Paolo, AU - Rela,Mohammed, AU - Wendon,Julia, AU - Heaton,Nigel D, AU - O'Grady,John G, AU - Heneghan,Michael A, PY - 2006/11/4/pubmed PY - 2006/12/23/medline PY - 2006/11/4/entrez SP - 988 EP - 94 JF - Transplant international : official journal of the European Society for Organ Transplantation JO - Transpl Int VL - 19 IS - 12 N2 - Allocation of donor livers through the model for end-stage liver disease (MELD) score has resulted in a fall in waiting list deaths in the United States. Change in MELD score (DeltaMELD) whilst awaiting transplant has been suggested as a method of refining organ allocation. Our aims were to analyse the effect of DeltaMELD between listing and transplant, and examine its impact on patient survival, intensive care stay and hospital stay in 402 patients transplanted for chronic liver disease at a single centre. Patients who had a DeltaMELD score of >+1 point were more likely to die in hospital following transplant (P < 0.05) and had a significantly worse 12- and 36-month survival post transplant (P < 0.0001) when compared with patients with DeltaMELD <or=+1 (77.8% vs. 91.9% at 12 months; 72.1% vs. 83.6% at 36 months). This difference persisted even when in-hospital deaths were excluded (P = 0.0148). In a Cox-proportional hazards model, factors associated with reduced survival were DeltaMELD (P = 0.008), and transplant from intensive care (P < 0.001). In conclusion, change in MELD score whilst on the transplant waiting list has a significant effect on survival post-transplant although MELD score at the time of transplant appears to have the most significant effect on resource utilization. SN - 0934-0874 UR - https://www.unboundmedicine.com/medline/citation/17081228/Change_in_model_for_end_stage_liver_disease_score_on_the_transplant_waiting_list_predicts_survival_in_patients_undergoing_liver_transplantation_ L2 - https://doi.org/10.1111/j.1432-2277.2006.00377.x DB - PRIME DP - Unbound Medicine ER -