BACKGROUND: Liver allocation in Eurotransplant (ET) is based on the MELD score. Interlaboratory MELD score differences in INR and creatinine determination have been reported. The clinical implication of this observation has not been demonstrated. METHODS: MELD scores were calculated in 66 patients with liver cirrhosis using bilirubin, creatinine, and INR analyzed in six liver transplant centers. Based on allocation results of ET, patients transplanted from December 2006 to June 2007 were divided according to MELD score in four groups. For each group, the influence of the match MELD on the probability of receiving a transplant was studied (Cox proportional hazards model). RESULTS: Laboratory-dependent significant differences in MELD score were demonstrated. Cox proportional hazards model showed a significant association between MELD score and the probability of organ allocation. The unadjusted hazard ratio for receiving a liver transplant was significantly different between group 2 and group 4 (group 2: MELD 19-24; group 4: MELD > 30). CONCLUSION: Laboratory-dependent significant differences in MELD score were observed between the six transplant centers. We demonstrated a significant association between the MELD score and the probability of organ allocation. The observed interlaboratory variation might yield a significant difference in organ allocation in patients with high MELD scores.
BACKGROUND: Liver allocation in Eurotransplant (ET) is based on the MELD score. Interlaboratory MELD score differences in INR and creatinine determination have been reported. The clinical implication of this observation has not been demonstrated. METHODS: MELD scores were calculated in 66 patients with liver cirrhosis using bilirubin, creatinine, and INR analyzed in six liver transplant centers. Based on allocation results of ET, patients transplanted from December 2006 to June 2007 were divided according to MELD score in four groups. For each group, the influence of the match MELD on the probability of receiving a transplant was studied (Cox proportional hazards model). RESULTS: Laboratory-dependent significant differences in MELD score were demonstrated. Cox proportional hazards model showed a significant association between MELD score and the probability of organ allocation. The unadjusted hazard ratio for receiving a liver transplant was significantly different between group 2 and group 4 (group 2: MELD 19-24; group 4: MELD > 30). CONCLUSION: Laboratory-dependent significant differences in MELD score were observed between the six transplant centers. We demonstrated a significant association between the MELD score and the probability of organ allocation. The observed interlaboratory variation might yield a significant difference in organ allocation in patients with high MELD scores.
Authors: Reham Abdel-Wahab; Manal M Hassan; Bhawana George; Roberto Carmagnani Pestana; Lianchun Xiao; Sahin Lacin; Suayib Yalcin; Ahmed S Shalaby; Humaid O Al-Shamsi; Kanwal Raghav; Robert A Wolff; James C Yao; Lauren Girard; Abedul Haque; Dan G Duda; Simona Dima; Irinel Popescu; Hesham A Elghazaly; Jean-Nicolas Vauthey; Thomas A Aloia; Ching-Wei Tzeng; Yun Shin Chun; Asif Rashid; Jeffrey S Morris; Hesham M Amin; Ahmed O Kaseb Journal: Oncology Date: 2020-10-07 Impact factor: 2.935
Authors: Thorsten Kaiser; Benedict Kinny-Köster; Michael Bartels; Thomas Berg; Markus Scholz; Cornelius Engelmann; Daniel Seehofer; Susen Becker; Uta Ceglarek; Joachim Thiery Journal: BMC Gastroenterol Date: 2017-04-20 Impact factor: 3.067