BACKGROUND & AIMS: A consensus has been reached that liver donor allocation should be based primarily on liver disease severity and that waiting time should not be a major determining factor. Our aim was to assess the capability of the Model for End-Stage Liver Disease (MELD) score to correctly rank potential liver recipients according to their severity of liver disease and mortality risk on the OPTN liver waiting list. METHODS: The MELD model predicts liver disease severity based on serum creatinine, serum total bilirubin, and INR and has been shown to be useful in predicting mortality in patients with compensated and decompensated cirrhosis. In this study, we prospectively applied the MELD score to estimate 3-month mortality to 3437 adult liver transplant candidates with chronic liver disease who were added to the OPTN waiting list at 2A or 2B status between November, 1999, and December, 2001. RESULTS: In this study cohort with chronic liver disease, 412 (12%) died during the 3-month follow-up period. Waiting list mortality increased directly in proportion to the listing MELD score. Patients having a MELD score <9 experienced a 1.9% mortality, whereas patients having a MELD score > or =40 had a mortality rate of 71.3%. Using the c-statistic with 3-month mortality as the end point, the area under the receiver operating characteristic (ROC) curve for the MELD score was 0.83 compared with 0.76 for the Child-Turcotte-Pugh (CTP) score (P < 0.001). CONCLUSIONS: These data suggest that the MELD score is able to accurately predict 3-month mortality among patients with chronic liver disease on the liver waiting list and can be applied for allocation of donor livers.
BACKGROUND & AIMS: A consensus has been reached that liver donor allocation should be based primarily on liver disease severity and that waiting time should not be a major determining factor. Our aim was to assess the capability of the Model for End-Stage Liver Disease (MELD) score to correctly rank potential liver recipients according to their severity of liver disease and mortality risk on the OPTN liver waiting list. METHODS: The MELD model predicts liver disease severity based on serum creatinine, serum total bilirubin, and INR and has been shown to be useful in predicting mortality in patients with compensated and decompensated cirrhosis. In this study, we prospectively applied the MELD score to estimate 3-month mortality to 3437 adult liver transplant candidates with chronic liver disease who were added to the OPTN waiting list at 2A or 2B status between November, 1999, and December, 2001. RESULTS: In this study cohort with chronic liver disease, 412 (12%) died during the 3-month follow-up period. Waiting list mortality increased directly in proportion to the listing MELD score. Patients having a MELD score <9 experienced a 1.9% mortality, whereas patients having a MELD score > or =40 had a mortality rate of 71.3%. Using the c-statistic with 3-month mortality as the end point, the area under the receiver operating characteristic (ROC) curve for the MELD score was 0.83 compared with 0.76 for the Child-Turcotte-Pugh (CTP) score (P < 0.001). CONCLUSIONS: These data suggest that the MELD score is able to accurately predict 3-month mortality among patients with chronic liver disease on the liver waiting list and can be applied for allocation of donor livers.
Authors: Harald Schrem; Melanie Reichert; Benedikt Reichert; Thomas Becker; Frank Lehner; Moritz Kleine; Hüseyin Bektas; Kai Johanning; Christian P Strassburg; Jürgen Klempnauer Journal: Langenbecks Arch Surg Date: 2011-12-06 Impact factor: 3.445
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Authors: Valentina Medici; Maria C Virata; Janet M Peerson; Sally P Stabler; Samuel W French; Jesse F Gregory; Anthony Albanese; Christopher L Bowlus; Sridevi Devaraj; Edward A Panacek; John R Richards; Charles H Halsted Journal: Alcohol Clin Exp Res Date: 2011-11 Impact factor: 3.455
Authors: Austin L Spitzer; Andre A S Dick; Ramasamy Bakthavatsalam; Jeffrey B Halldorson; Paolo R Salvalaggio; Jorge D Reyes; James D Perkins Journal: HPB (Oxford) Date: 2010-04 Impact factor: 3.647
Authors: Neil Mehta; Jennifer L Dodge; Aparna Goel; John Paul Roberts; Ryutaro Hirose; Francis Y Yao Journal: Liver Transpl Date: 2013-12 Impact factor: 5.799
Authors: Aditya Bansal; Jay K Bhama; Rajan Patel; Sapna Desai; Stacy A Mandras; Hamang Patel; Tyrone Collins; John P Reilly; Hector O Ventura; P Eugene Parrino Journal: Ochsner J Date: 2016