title: Results after the adoption of a MELD/PELD-based liver allocation policy in Argentina.
abstract: In July 2005, Argentina switched from a categorical liver allocation system to a MELD/PELD-based policy for patients with CLD. To analyze WL outcomes and survival after LT in children. From January 2000 to December 2010, 923 children were registered. Two consecutive five-yr periods were analyzed and compared: Era I (January 2000-July 2005) (n = 379) and Era II (July 2005-December 31, 2010) (n = 544). All data were prospectively collected and analyzed using the Kaplan-Meier method. After adopting the MELD/PELD system, WL registrations increased by 44% (from 379 to 544) and the number of LT increased by only 24% (from 278 to 365). However, three-month WL mortality rate (32% to 18%, p < 0.0001, HR 2.002 CI 95% 1.5-2.8) decreased significantly. No significant differences were observed between Era 1 and II in one-yr post-LT survival (77.5% vs. 84.1%, p = 0.3053) and in acute re-LT rate (9% vs. 5%, p = 0.1746). Under the MELD/PELD-based allocation system in Argentina, mortality on the WL significantly decreased in children with CLD without affecting post-LT survival, although reduced access to LT was observed.
authors.affiliation: Sociedad Argentina de Trasplante, Ciudad Autonoma de Buenos Aires, Argentina; Instituto Nacional Central Unico Coordinador de Ablación e Implante (INCUCAI), Ciudad Autonoma de Buenos Aires, Argentina; Hospital de Pediatría Prof. Dr. JP Garrahan, Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Dip
authors.forename: Nora
authors.initials: N
authors.lastname: Cejas
authors.forename: Guillermo
authors.initials: G
authors.lastname: Cervio
authors.forename: Federico
authors.initials: F
authors.lastname: Villamil
authors.forename: Viviana
authors.initials: V
authors.lastname: Tagliafichi
authors.forename: Daniela
authors.initials: D
authors.lastname: Hansen Krogh
authors.forename: Oscar
authors.initials: O
authors.lastname: Imventarza
authors.forename: Carlos
authors.initials: C
authors.lastname: Soratti
authors.forename: Liliana
authors.initials: L
authors.lastname: Bisigniano
mesh_terms: D000293:Adolescent; D001118:Argentina; D002648:Child; D002675:Child, Preschool; D058625:End Stage Liver Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008297:Male; D011446:Prospective Studies; D015996:Survival Rate; D009927:Tissue and Organ Procurement / Q000592:standards*
keywords: liver transplant; pediatric; pediatric end-stage liver disease impact survival; waiting list mortality; waiting list outcomes