title: Does the meld system provide equal access to liver transplantation for patients with different ABO blood groups?
abstract: This study investigates the relationship between blood group and waiting time until transplantation or death on the waiting list. All patients listed for liver transplantation in the Netherlands between 15 December 2006 and 31 December 2012, were included. Study variables were gender, age, year of listing, diagnosis, previous transplantations, blood group, urgency, and MELD score. Using a competing risks analysis, separate cumulative incidence curves were constructed for death on the waiting list and transplantation and used to evaluate outcomes.In 517 listings, the mean death rate per 100 patient-years was 10.4. A total of 375 (72.5% of all listings) were transplanted. Of all transplantations, 352 (93.9%) were ABO-identical and 23 (6.1%) ABO-compatible. The 5-year cumulative incidence of death was 11.2% (SE 1.4%), and of transplantation 72.5% (SE 2.0%). Patient blood group had no multivariate significant impact on the hazard of dying on the waiting list nor on transplantation. Age, MELD score, and urgency status were significantly related to the death on the waiting list and transplantation. More recent listing had higher probability of being transplanted. In the MELD era, patient blood group status does not have a significant impact on liver transplant waiting list mortality nor on waiting time for transplantation.
authors.affiliation: Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Alexander J C
authors.initials: AJ
authors.lastname: IJtsma
authors.affiliation: Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Christian S
authors.initials: CS
authors.lastname: van der Hilst
authors.affiliation: Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Nijkamp
authors.affiliation: Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Jan T
authors.initials: JT
authors.lastname: Bottema
authors.affiliation: Unaffiliated Medical Statistician, Haren GN, The Netherlands.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Fidler
authors.affiliation: Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Porte
authors.affiliation: Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Maarten J H
authors.initials: MJ
authors.lastname: Slooff
mesh_terms: D000017:ABO Blood-Group System; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D002648:Child; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008099:Liver / Q000601:surgery*; D017093:Liver Failure / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014850:Waiting Lists
chemical_list: D000017:ABO Blood-Group System
keywords: donation; donor registries; liver clinical; outcome; selection criteria