Liver transplantation for hepatocellular carcinoma: Lessons from the first year under the Model of End-Stage Liver Disease (MELD) organ allocation policy

2004 ◽  
Vol 10 (5) ◽  
pp. 621-630 ◽  
Author(s):  
Francis Y. Yao ◽  
Nathan M. Bass ◽  
Nancy L. Ascher ◽  
John P. Roberts
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Liver Disease ◽  
Organ Allocation ◽  
First Year ◽  
Allocation Policy ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Mortality and its Determinants in Adult Patients with End-stage Liver Disease on Waiting List for Liver Transplantation: A Preliminary Report on Baseline Data

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Kamran Bagheri Lankarani ◽  
Behnam Honarvar ◽  
Mohammad Reza Rouhezamin ◽  
Hadi Raeisi Shahraki ◽  
Vahid Seifi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Weight Loss ◽  
Liver Disease ◽  
Gallbladder Wall ◽  
Meld Score ◽  
Organ Allocation ◽  
Ca 125 ◽  
End Stage Liver Disease ◽  
History Of ◽  
End Stage

Background: Prevention of death in patients on the waiting list for liver transplantation (LT) is a major concern to prioritize organ allocation. Since the model for the end-stage liver disease (MELD) and its modifications have many shortages, there is a need for further refinement of the allocation strategy. Objectives: The current study aimed at assessing the predictors of mortality in LT candidates in a more comprehensive manner with the possible implications to improve the care of such patients and assist in developing better strategies for organ allocation. Methods: In the current cohort study, 544 adult LT candidates with end-stage liver disease were followed up for a mean of 12 months in three-month intervals. Data analysis was performed in Nutritionist, SPSS, and R software, using Kaplan-Meier, Cox proportional hazard (HRC), and LASSO Cox regression hazard (HRL) tests. Results: The mean age of the patients was 46.7 ± 13.7 years; the majority were male (n = 336, 61.7%). At the end of the study, 414 (76.1%) subjects were still alive and 130 (23.9%) dead. The cumulative percentages of death were 33.1%, 57.7%, and 79.2% after 3, 6, and 12 months of waiting for a donor, respectively. Although there was a strong association between having hepatopulmonary syndrome (HPS) (HRC = 4.7, HRL = 1.8), a history of myocardial infarction (MI) (HRC = 3.3, HRL = 1.6), low-carbohydrate (CHO) diet (HRC = 2.7, HRL = 1.5), and mortality, it was weak for MELD score. Moreover, a serum level of CA 125, high polymorphonuclear (PMN) count, weight loss, a high level of alanine aminotransferase (ALT), positive hepatitis B virus (HBV) markers, high mean corpuscular volume (MCV) of red blood cells, ascites, and edema of gallbladder wall had association with mortality in LT patients. Conclusions: In addition to MELD score, HPS, a history of MI, low CHO intake, weight loss, ascites, PMN, CA 125, ALT, hepatitis B surface antigen, MCV, blood urea nitrogen, and gallbladder wall thickness are predictors of mortality in LT candidates and need to be considered in the LT allocation system.

Liver Transplantation for Hepatocellular Carcinoma in the Model for End-Stage Liver Disease Era

2010 ◽  
Vol 210 (5) ◽  
pp. 727-734 ◽  
Author(s):  
David M. Levi ◽  
Andreas G. Tzakis ◽  
Paul Martin ◽  
Seigo Nishida ◽  
Eddie Island ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Liver Disease ◽  
End Stage Liver Disease ◽  
End Stage

Impact of the Model for End-Stage Liver Disease Allocation Policy on the Use of High-Risk Organs for Liver Transplantation

2008 ◽  
Vol 135 (5) ◽  
pp. 1568-1574 ◽  
Author(s):  
Michael L. Volk ◽  
Anna S.F. Lok ◽  
Shawn J. Pelletier ◽  
Peter A. Ubel ◽  
Rodney A. Hayward
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
High Risk ◽  
Allocation Policy ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Inequity in organ allocation for patients awaiting liver transplantation: Rationale for uncapping the model for end-stage liver disease

2017 ◽  
Vol 67 (3) ◽  
pp. 517-525 ◽  
Author(s):  
Mitra K. Nadim ◽  
Joseph DiNorcia ◽  
Lingyun Ji ◽  
Susan Groshen ◽  
Josh Levitsky ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Organ Allocation ◽  
End Stage Liver Disease ◽  
End Stage
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