A Share 21 model in liver transplantation: Impact on waitlist outcomes

Document Type

Article

Publication Date

3-10-2020

Publication Title

American journal of transplantation

Abstract

With the introduction of Model for End-Stage Liver Disease-Sodium (MELD-Na)-based allocation, the score at which patients benefit from liver transplantation (LT) has shifted from a score of 15 to 21. This study aimed to evaluate waitlist outcomes in patients with MELD-Na scores"Share 15" with "Share 21." The study uses data from the Organ Procurement and Transplantation Network/United Network for Organ Sharing registry. All adult patients registered for LT after implementation of the MELD-Na-based allocation were evaluated. Waitlist patients with initial and final scoresmodel, patients with an initial MELD-Na score of 6-14 (Group 1) and those with a score of 15-20 (Group 2) were compared for waitlist outcomes. There were 3686 patients with an initial score of 6-14 (Group 1) and 3282 with a score of 15-20 (Group 2). Group 2, when compared to Group 1, showed comparable risk of mortality (adjusted hazard ratio [aHR] 1.00, P = .97), higher transplant probability (aHR 3.25, P < .001), and lower likelihood of removal from listing because of improvement (aHR 0.74, P = .011). Share 21 may enhance transplant opportunities and increase parity for patients with higher MELD-Na scores without compromising waitlist outcomes.

Medical Subject Headings

Adult; End Stage Liver Disease/surgery; Humans; Liver Transplantation; Severity of Illness Index; Tissue and Organ Procurement; Waiting Lists; Organ Procurement and Transplantation Network (OPTN); United Network for Organ Sharing (UNOS); clinical research/practice; donors and donation: deceased; liver disease; liver transplantation/hepatology; organ procurement and allocation; waitlist management

PubMed ID

32155314

ePublication

ePub ahead of print

Volume

20

Issue

8

First Page

2184

Last Page

2197

Find It @ Sladen

Share

COinS