Tags

Type your tag names separated by a space and hit enter

D-MELD, a simple predictor of post liver transplant mortality for optimization of donor/recipient matching.
Am J Transplant 2009; 9(2):318-26AJ

Abstract

Numerous donor and recipient risk factors interact to influence the probability of survival after liver transplantation. We developed a statistic, D-MELD, the product of donor age and preoperative MELD, calculated from laboratory values. Using the UNOS STAR national transplant data base, we analyzed survival for first liver transplant recipients with chronic liver failure from deceased after brain death donors. Preoperative D-MELD score effectively stratified posttransplant survival. Using a cutoff D-MELD score of 1600, we defined a subgroup of donor-recipient matches with significantly poorer short- and long-term outcomes as measured by survival and length of stay (LOS). Avoidance of D-MELD scores above 1600 improved results for subgroups of high-risk patients with donor age >/=60 and those with preoperative MELD >/=30. D-MELD >/=1600 accurately predicted worse outcome in recipients with and without hepatitis C. There is significant regional variation in average D-MELD scores at transplant, however, regions with larger numbers of high D-MELD matches do not have higher survival rates. D-MELD is a simple, highly predictive tool for estimating outcomes after liver transplantation. This statistic could assist surgeons and their patients in making organ acceptance decisions. Applying D-MELD to liver allocation could eliminate many donor/recipient matches likely to have inferior outcome.

Authors+Show Affiliations

Division of Transplantation, Department of Surgery, University of Washington, Seattle, WA, USA. jhalldor@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

19120079

Citation

Halldorson, J B., et al. "D-MELD, a Simple Predictor of Post Liver Transplant Mortality for Optimization of Donor/recipient Matching." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol. 9, no. 2, 2009, pp. 318-26.
Halldorson JB, Bakthavatsalam R, Fix O, et al. D-MELD, a simple predictor of post liver transplant mortality for optimization of donor/recipient matching. Am J Transplant. 2009;9(2):318-26.
Halldorson, J. B., Bakthavatsalam, R., Fix, O., Reyes, J. D., & Perkins, J. D. (2009). D-MELD, a simple predictor of post liver transplant mortality for optimization of donor/recipient matching. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 9(2), pp. 318-26. doi:10.1111/j.1600-6143.2008.02491.x.
Halldorson JB, et al. D-MELD, a Simple Predictor of Post Liver Transplant Mortality for Optimization of Donor/recipient Matching. Am J Transplant. 2009;9(2):318-26. PubMed PMID: 19120079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - D-MELD, a simple predictor of post liver transplant mortality for optimization of donor/recipient matching. AU - Halldorson,J B, AU - Bakthavatsalam,R, AU - Fix,O, AU - Reyes,J D, AU - Perkins,J D, Y1 - 2008/12/15/ PY - 2009/1/6/entrez PY - 2009/1/6/pubmed PY - 2009/3/27/medline SP - 318 EP - 26 JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. VL - 9 IS - 2 N2 - Numerous donor and recipient risk factors interact to influence the probability of survival after liver transplantation. We developed a statistic, D-MELD, the product of donor age and preoperative MELD, calculated from laboratory values. Using the UNOS STAR national transplant data base, we analyzed survival for first liver transplant recipients with chronic liver failure from deceased after brain death donors. Preoperative D-MELD score effectively stratified posttransplant survival. Using a cutoff D-MELD score of 1600, we defined a subgroup of donor-recipient matches with significantly poorer short- and long-term outcomes as measured by survival and length of stay (LOS). Avoidance of D-MELD scores above 1600 improved results for subgroups of high-risk patients with donor age >/=60 and those with preoperative MELD >/=30. D-MELD >/=1600 accurately predicted worse outcome in recipients with and without hepatitis C. There is significant regional variation in average D-MELD scores at transplant, however, regions with larger numbers of high D-MELD matches do not have higher survival rates. D-MELD is a simple, highly predictive tool for estimating outcomes after liver transplantation. This statistic could assist surgeons and their patients in making organ acceptance decisions. Applying D-MELD to liver allocation could eliminate many donor/recipient matches likely to have inferior outcome. SN - 1600-6143 UR - https://www.unboundmedicine.com/medline/citation/19120079/D_MELD_a_simple_predictor_of_post_liver_transplant_mortality_for_optimization_of_donor/recipient_matching_ L2 - https://doi.org/10.1111/j.1600-6143.2008.02491.x DB - PRIME DP - Unbound Medicine ER -