Tags

Type your tag names separated by a space and hit enter

Survival before and after model for end-stage liver disease score introduction on the Brazilian liver transplant waiting list.
Transplant Proc. 2010 Mar; 42(2):412-6.TP

Abstract

INTRODUCTION

To examine whether the official adoption of Model for End-Stage Liver Disease (MELD) as a criterion for organ allocation was effective, we studied risk factors for patient deaths and the accuracy of the MELD score to predict mortality.

METHODS

Patients on the waiting list for liver transplantation were divided into two periods depending on whether they were on the waiting list before (period 1) or after (period 2) the MELD introduction in Brazil. The Kaplan-Meier method with log-rank tests were used to study patient survivals. Predictive factors were identified using the Cox regression method. A receiver operating characteristic (ROC) curve was used to analyze Child-Turcotte-Pugh (CTP) and MELD accuracy.

RESULTS

We analyzed 295 patients in period 1 and 240 in period 2. The survivals after 3, 6, 9, and 12 months in periods 1 and 2, were 95.6%, 90.5%, 84.9%, and 69.6% vs 95.7%, 92.1%, 85.3%, and 83.3%, respectively (P = NS). Multivariate analysis showed CTP, MELD-Na, and albumin levels, besides spontaneous bacterial peritonitis (SBP), to be independent factors related to survival in period 1. In period 2, CTP, creatinine levels, international normalized ratio, besides spontaneous bacterial peritonitis, were the independent factors. The ROC curve for CTP was 0.676 and for MELD, 0.644 (P = .4) in period 1. In period 2, the ROC curve for CTP was 0.680 and for MELD, 0.718 (P = .4).

CONCLUSION

Patient survival on the waiting list for liver transplantation did not change at 1 year after the introduction of the MELD.

Authors+Show Affiliations

Gastrocentro, Unit of Liver Transplantation, State University of Campinas, Campinas, 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

20304153

Citation

Castro, R S., et al. "Survival Before and After Model for End-stage Liver Disease Score Introduction On the Brazilian Liver Transplant Waiting List." Transplantation Proceedings, vol. 42, no. 2, 2010, pp. 412-6.
Castro RS, Deisanti D, Seva-Pereira T, et al. Survival before and after model for end-stage liver disease score introduction on the Brazilian liver transplant waiting list. Transplant Proc. 2010;42(2):412-6.
Castro, R. S., Deisanti, D., Seva-Pereira, T., Almeida, J. R., Yamanaka, A., Boin, I. F., & Soares, E. C. (2010). Survival before and after model for end-stage liver disease score introduction on the Brazilian liver transplant waiting list. Transplantation Proceedings, 42(2), 412-6. https://doi.org/10.1016/j.transproceed.2010.01.028
Castro RS, et al. Survival Before and After Model for End-stage Liver Disease Score Introduction On the Brazilian Liver Transplant Waiting List. Transplant Proc. 2010;42(2):412-6. PubMed PMID: 20304153.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival before and after model for end-stage liver disease score introduction on the Brazilian liver transplant waiting list. AU - Castro,R S, AU - Deisanti,D, AU - Seva-Pereira,T, AU - Almeida,J R S, AU - Yamanaka,A, AU - Boin,I F S F, AU - Soares,E C, PY - 2010/3/23/entrez PY - 2010/3/23/pubmed PY - 2010/8/20/medline SP - 412 EP - 6 JF - Transplantation proceedings JO - Transplant Proc VL - 42 IS - 2 N2 - INTRODUCTION: To examine whether the official adoption of Model for End-Stage Liver Disease (MELD) as a criterion for organ allocation was effective, we studied risk factors for patient deaths and the accuracy of the MELD score to predict mortality. METHODS: Patients on the waiting list for liver transplantation were divided into two periods depending on whether they were on the waiting list before (period 1) or after (period 2) the MELD introduction in Brazil. The Kaplan-Meier method with log-rank tests were used to study patient survivals. Predictive factors were identified using the Cox regression method. A receiver operating characteristic (ROC) curve was used to analyze Child-Turcotte-Pugh (CTP) and MELD accuracy. RESULTS: We analyzed 295 patients in period 1 and 240 in period 2. The survivals after 3, 6, 9, and 12 months in periods 1 and 2, were 95.6%, 90.5%, 84.9%, and 69.6% vs 95.7%, 92.1%, 85.3%, and 83.3%, respectively (P = NS). Multivariate analysis showed CTP, MELD-Na, and albumin levels, besides spontaneous bacterial peritonitis (SBP), to be independent factors related to survival in period 1. In period 2, CTP, creatinine levels, international normalized ratio, besides spontaneous bacterial peritonitis, were the independent factors. The ROC curve for CTP was 0.676 and for MELD, 0.644 (P = .4) in period 1. In period 2, the ROC curve for CTP was 0.680 and for MELD, 0.718 (P = .4). CONCLUSION: Patient survival on the waiting list for liver transplantation did not change at 1 year after the introduction of the MELD. SN - 1873-2623 UR - https://www.unboundmedicine.com/medline/citation/20304153/Survival_before_and_after_model_for_end_stage_liver_disease_score_introduction_on_the_Brazilian_liver_transplant_waiting_list_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-1345(10)00119-3 DB - PRIME DP - Unbound Medicine ER -