Model for End-Stage Liver Disease (MELD) and allocation of donor livers
Model for End-Stage Liver Disease (MELD) and allocation of donor livers
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DOI：
10.1053/gast.2003.50016
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发表时间：
2003-01-01
期刊：
影响因子：
29.4
通讯作者：
Krom, R
中科院分区：
文献类型：
--
作者：
Wiesner, R;Edwards, E;Krom, R
背景与目的：目前已达成共识，认为肝脏捐赠者的分配应该主要基于肝脏疾病的严重程度，等待时间不应该是主要的决定因素。我们的目的是评估终末期肝病模型(MELD)评分是否能够根据OPTN肝脏等待名单上的肝脏疾病严重程度和死亡风险正确地对潜在的肝脏接受者进行排名。方法：MELD模型根据血清肌酐、血清总胆红素和INR预测肝脏疾病的严重程度，并已被证明在预测代偿期和失代偿期肝硬变患者的死亡率方面是有用的。在这项研究中，我们前瞻性地应用MELD评分来估计3437名患有慢性肝病的成年肝移植患者的3个月死亡率，这些患者在1999年11月至2001年12月期间被添加到OPTN等待名单中，状态为2A或213。结果：在这项慢性肝病队列研究中，412人(12%)在3个月的随访期内死亡。等待名单死亡率与上市MELD分数成正比。有MELD评分的患者
Background & Aims: A consensus has been reached that liver donor allocation should be based primarily on liver disease severity and that waiting time should not be a major determining factor. Our aim was to assess the capability of the Model for End-Stage Liver Disease (MELD) score to correctly rank potential liver recipients according to their severity of liver disease and mortality risk on the OPTN liver waiting list. Methods: The MELD model predicts liver disease severity based on serum creatinine, serum total bilirubin, and INR and has been shown to be useful in predicting mortality in patients with compensated and decompensated cirrhosis. In this study, we prospectively applied the MELD score to estimate 3-month mortality to 3437 adult liver transplant candidates with chronic liver disease who were added to the OPTN waiting list at 2A or 213 status between November, 1999, and December, 2001. Results: In this study cohort with chronic liver disease, 412 (12%) died during the 3-month follow-up period. Waiting list mortality increased directly in proportion to the listing MELD score. Patients having a MELD score