Tags

Type your tag names separated by a space and hit enter

Survival on waiting list for liver transplantation before and after introduction of the model for end-stage liver disease score.
Transplant Proc. 2010 Mar; 42(2):407-11.TP

Abstract

BACKGROUND

Since July 2006, the Model for End-stage Liver Disease (MELD) score has served as the national basis for allocation of donor livers for transplantation in Brazil. Patients with higher MELD scores receive greater priority for allocation regardless of the time on the waiting list.

PURPOSE

To investigate the impact of MELD score implementation on the survival of waiting list patients.

METHODS

A retrospective study of patients registered at the national Organ Procurement Organization (OPO) for the liver transplantation waiting list between January 2004 and June 2006 (pre-MELD) and between July 2006 and December 2008 (post-MELD).

RESULTS

We included listed patients awaiting liver transplantation in the pre-MELD era (n = 250, 48.4%) and in the post-MELD era (n = 266, 51.6%). The times awaiting transplant prior to and after the MELD system were 487.2 +/- 384.8 days and 183.9 +/- 157.2 days, respectively. Prior to the MELD score, waiting list survivals were greater when compared to rates in the current system. Early posttransplant patient survival rates were significantly reduced in the post-MELD era (83.4%) compared to the period before MELD implementation (93.2%).

CONCLUSIONS

MELD score provides a transparent, objective system to drive allocation policy; however, it presents several important limitations. Constant need of changes and reevaluation are needed as an evolutionary process. Future changes in the present system may be addressed by adjusting the MELD system.

Authors+Show Affiliations

Department of Surgery and Liver Transplantation, Oswaldo Cruz University Hospital, University of Pernambuco School of Medicine, Recife, Brazil.No 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

20304152

Citation

Tenório, A L., et al. "Survival On Waiting List for Liver Transplantation Before and After Introduction of the Model for End-stage Liver Disease Score." Transplantation Proceedings, vol. 42, no. 2, 2010, pp. 407-11.
Tenório AL, Macedo FI, Miranda LE, et al. Survival on waiting list for liver transplantation before and after introduction of the model for end-stage liver disease score. Transplant Proc. 2010;42(2):407-11.
Tenório, A. L., Macedo, F. I., Miranda, L. E., Fernandes, J. L., da Silva, C. M., Neto, O. L., & Lacerda, C. M. (2010). Survival on waiting list for liver transplantation before and after introduction of the model for end-stage liver disease score. Transplantation Proceedings, 42(2), 407-11. https://doi.org/10.1016/j.transproceed.2010.01.005
Tenório AL, et al. Survival On Waiting List for Liver Transplantation Before and After Introduction of the Model for End-stage Liver Disease Score. Transplant Proc. 2010;42(2):407-11. PubMed PMID: 20304152.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival on waiting list for liver transplantation before and after introduction of the model for end-stage liver disease score. AU - Tenório,A L, AU - Macedo,F I B, AU - Miranda,L E C, AU - Fernandes,J L, AU - da Silva,C M, AU - Neto,O L F, AU - Lacerda,C M, PY - 2010/3/23/entrez PY - 2010/3/23/pubmed PY - 2010/8/20/medline SP - 407 EP - 11 JF - Transplantation proceedings JO - Transplant Proc VL - 42 IS - 2 N2 - BACKGROUND: Since July 2006, the Model for End-stage Liver Disease (MELD) score has served as the national basis for allocation of donor livers for transplantation in Brazil. Patients with higher MELD scores receive greater priority for allocation regardless of the time on the waiting list. PURPOSE: To investigate the impact of MELD score implementation on the survival of waiting list patients. METHODS: A retrospective study of patients registered at the national Organ Procurement Organization (OPO) for the liver transplantation waiting list between January 2004 and June 2006 (pre-MELD) and between July 2006 and December 2008 (post-MELD). RESULTS: We included listed patients awaiting liver transplantation in the pre-MELD era (n = 250, 48.4%) and in the post-MELD era (n = 266, 51.6%). The times awaiting transplant prior to and after the MELD system were 487.2 +/- 384.8 days and 183.9 +/- 157.2 days, respectively. Prior to the MELD score, waiting list survivals were greater when compared to rates in the current system. Early posttransplant patient survival rates were significantly reduced in the post-MELD era (83.4%) compared to the period before MELD implementation (93.2%). CONCLUSIONS: MELD score provides a transparent, objective system to drive allocation policy; however, it presents several important limitations. Constant need of changes and reevaluation are needed as an evolutionary process. Future changes in the present system may be addressed by adjusting the MELD system. SN - 1873-2623 UR - https://www.unboundmedicine.com/medline/citation/20304152/Survival_on_waiting_list_for_liver_transplantation_before_and_after_introduction_of_the_model_for_end_stage_liver_disease_score_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-1345(10)00090-4 DB - PRIME DP - Unbound Medicine ER -