The value of MELD and sodium in assessing potential liver transplant recipients in the United Kingdom.
As the result of the widening gap between supply and demand of organs for liver transplantation, efforts to improve allocation have become an increasingly important yet controversial subject. The MELD score has been adopted in the USA but its usefulness has rarely been examined in Europe. We carried out an intention to treat analysis of 422 patients placed on our transplant waiting list over a 5-year period. We examined multiple variables to investigate the value of MELD, sodium and other factors in predicting post-transplant outcomes. MELD at transplant was the most important indicator of post-transplant outcomes. In addition, delta-MELD and hyponatreamia were significant at predicting, which patients placed on the waiting list would not proceed to transplant. While a move to allocating solely by MELD is not justified in the UK allocation system, there is value in using MELD, delta-MELD and hyponatreamia in making decisions regarding the allocation of organs. This may subsequently help to improve overall outcomes.
Young
Alastair L
AL
Department of Organ Transplantation, St James's University Hospital, Leeds, UK.
Rajagenashan
Rajasundurum
R
Asthana
Sonal
S
Peters
Christopher J
CJ
Toogood
Giles J
GJ
Davies
Mervyn H
MH
Lodge
J Peter A
JP
Pollard
Stephen G
SG
Prasad
K Rajendra
KR
D001663:Bilirubin / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood*; D015996:Survival Rate; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000706:statistics & numerical data; D019737:Transplants / Q000600:supply & distribution; D006113:United Kingdom / Q000453:epidemiology; D014850:Waiting Lists
D012964:Sodium; D003404:Creatinine; D001663:Bilirubin