title: [Analysis of liver waiting list mortality in Paraná, Brazi: what shall we do to face organ shortage?].
abstract: BACKGROUND
  Orthotopic liver transplantation is the best therapeutic modality for patients with end stage of liver disease. Minimization of death, while waiting for the procedure, involves accurate priorization according to clinical status and appropriate allocation of donor livers.
  
  
  OBJECTIVE
  The mortality analysis in the liver waiting list in Paraná state, PR, Brazil.
  
  
  METHODS
  Were analyzed the data on all patients (n = 65) who were registered on the liver waiting list during a 32 months period in the state of Paraná, southern Brazil.
  
  
  RESULTS
  The death rated in waiting list was 41,5% (n = 27). No statistic difference was observed regarding the MELD/MELD-Na scores between the group who died (19,88/21,6) and not died (17,28/19,47). MELD-Na predicted a higher mortality, especially in the subgroup of patients with intermediate severity of disease (class B) predicted by the CTP score.
  
  
  CONCLUSIONS
  It´s critical the shortage of donor organs in our region, waiting list mortality rate far exceeds the inherent risk of a liver transplant, especially among patients with lower MELD scores. It´s desirable to use an aggressive protocol of expanded criteria donors, split liver and living donor transplant.
authors: Trabalho realizado Instituto para Cuidadodo Fígado (www.icfigado.org), Curitiba, PR, Brazil. silveira.fabio@gmail.com
authors: Fábio
authors: F
authors: Silveira
authors: Fábio Porto
authors: FP
authors: Silveira
authors: Matheus Martin
authors: MM
authors: Macri
authors: João Eduardo Leal
authors: JE
authors: Nicoluzzi
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D014850:Waiting Lists / Q000401:mortality*; D055815:Young Adult