Aetiology of cirrhosis of the liver has an impact on survival predicted by the Model of End‐stage Liver Disease score

Angermayr, Bernhard; Luca, Angelo; König, Franz; Bertolini, Guido; Ploner, Martin; Gridelli, Bruno; Ulbrich, G.; Reiberger, Thomas; Bosch, Jaime; Peck‐Radosavljevic, Markus

doi:10.1111/j.1365-2362.2008.02063.x

Cited by 17 publications

(14 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A liver transplant to an alcoholic, for example, is assumed to have lower success rates than to non-alcoholics, and the concern for high recidivism rates is explained as a reason for lower priority to alcoholics. Empirical evidence indicates, however, that transplants to victims of alcoholic cirrhosis may have better prognosis than victims of viral cirrhosis, and that relapse rate after transplantation is quite low 13 14…”

Section: Discussionmentioning

confidence: 99%

On the relevance of personal responsibility in priority setting: a cross-sectional survey among Norwegian medical doctors

Bringedal

Feiring

2011

J Med Ethics

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

On the relevance of personal responsibility in priority setting: a cross-sectional survey among Norwegian medical doctors

Bringedal

Feiring

2011

J Med Ethics

View full text Add to dashboard Cite

show abstract

“…Concerning the alcoholic etiology of liver disease, it is worth noticing that some authors have raised the question of cirrhotic patients due to alcoholism having a better outcome without transplantation than cirrhotics due to viral hepatitis (2) , and others have found that alcoholic patients had more post-transplant complications (30) . Both these remarks could reinforce that the reported trend in listing and transplanting less alcoholic patients might be positive to the system as a whole.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Survival of Cirrhotic Patients Enlisted for Liver Transplantation in the Pre- And Post-Meld Era in Southern Brazil

Mattos

Sacco

Hoppe

et al. 2014

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Context -Transplantation is the only cure for decompensated cirrhosis. Model for End-Stage Liver Disease (MELD) is used in liver allocation. Objectives -Comparing survival of enlisted populations in pre-and post-MELD eras and estimating their long-term survival. Methods -This is a retrospective study of cirrhotics enlisted for transplantation during pre-and post-MELD eras. Survival curves were generated using Kaplan-Meier's model. Cox's model was used to determine risk factors for mortality. Exponential, Weibull's, normal-log and Gompertz's models were used to estimate long-term survival. Results -The study included 162 patients enlisted in pre-MELD era and 184 in post-MELD period. Kaplan-Meier's survival curve of patients enlisted in post-MELD era was better than that of pre-MELD period (P = 0.009). This difference remained for long-term estimates, with a survival of 53.54% in 5 years and 44.64% in 10 years for patients enlisted in post-MELD era and of 43.17% and 41.75% for pre-MELD period. Era in which patients had been enlisted (P = 0.010) and MELD score at enlistment (P<0.001) were independently associated to survival with hazard ratios of 0.664 (95% CI-confidence interval = 0.487-0.906) and 1.069 (95% CI = 1.043-1.095). Conclusion -MELDbased transplantation policy is superior to chronology-based one, promoting better survival for enlisted patients, even in long-term.

show abstract

“…Nevertheless, Angermayr et al found that the prediction of survival beyond three months in patients with viral cirrhosis and MELD P16 is not precisely assessed [65]. Moreover, Lucey et al demonstrated that MELD is a stronger predictor of waitlist mortality in non-alcoholic than alcoholic patients [66].…”

Section: Other Potential Pitfallsmentioning

confidence: 97%

The MELD score in patients awaiting liver transplant: Strengths and weaknesses

Bernardi

Gitto

Biselli

2011

Journal of Hepatology

155

127

View full text Add to dashboard Cite

Adoption of the Model for End-stage Liver Disease (MELD) to select and prioritize patients for liver transplantation represented a turning point in organ allocation. Prioritization of transplant recipients switched from time accrued on the waiting list to the principle of "sickest first". The MELD score incorporates three simple laboratory parameters (serum creatinine and bilirubin, and INR for prothrombin time) and stratifies patients according to their disease severity in an objective and continuous ranking scale. Concordance statistics have demonstrated its high accuracy in stratifying patients according to their risk of dying in the short-term (three months). Further validations of MELD as a predictor of survival at various temporal end-points have been obtained in independent patient cohorts with a broad spectrum of chronic liver disease. The MELD-based liver graft allocation policy has led to a reduction in waitlist new registrations and mortality, shorter waiting times, and an increase in transplants, without altering overall graft and patient survival rates after transplantation. MELD limitations are related either to the inter-laboratory variability of the parameters included in the score, or to the inability of the formula to predict mortality accurately in specific settings. For some conditions, such as hepatocellular carcinoma, widely accepted MELD corrections have been devised. For others, such as persistent ascites and hyponatremia, attempts to improve MELD's predicting power are currently underway, but await definite validation.

show abstract

Aetiology of cirrhosis of the liver has an impact on survival predicted by the Model of End‐stage Liver Disease score

Cited by 17 publications

References 25 publications

On the relevance of personal responsibility in priority setting: a cross-sectional survey among Norwegian medical doctors

On the relevance of personal responsibility in priority setting: a cross-sectional survey among Norwegian medical doctors

Analysis of the Survival of Cirrhotic Patients Enlisted for Liver Transplantation in the Pre- And Post-Meld Era in Southern Brazil

The MELD score in patients awaiting liver transplant: Strengths and weaknesses

Contact Info

Product

Resources

About