|Reference : The influence of laboratory-induced Meld score differences on liver allocation: more rea...|
|Scientific journals : Article|
|Human health sciences : Gastroenterology & hepatology|
|The influence of laboratory-induced Meld score differences on liver allocation: more reality than myth.|
|Schouten, J. N. [ > > ]|
|Francque, S. [ > > ]|
|Van Vlierberghe, H. [ > > ]|
|Colle, I. [ > > ]|
|Nevens, F. [ > > ]|
|DELWAIDE, Jean [Centre Hospitalier Universitaire de Liège - CHU > > Gastro-Entérologie-Hépatologie >]|
|Adler, M. [ > > ]|
|Starkel, P. [ > > ]|
|Ysebaert, D. [ > > ]|
|Gadisseur, A. [ > > ]|
|De Winter, B. [ > > ]|
|Smits, J. [ > > ]|
|Rahmel, A. [ > > ]|
|Michielsen, P. [ > > ]|
|[en] allocation – bilirubin – creatinine – international normalized ratio – liver transplantation – MELD score|
|[en] Background: Liver allocation in Eurotransplant (ET) is based on
the MELD score. Interlaboratory MELD score differences in INR and
creatinine determination have been reported. The clinical implication of this
observation has not been demonstrated.
Methods: MELD scores were calculated in 66 patients with liver cirrhosis
using bilirubin, creatinine, and INR analyzed in six liver transplant centers.
Based on allocation results of ET, patients transplanted from December
2006 to June 2007 were divided according to MELD score in four groups.
For each group, the influence of the match MELD on the probability of
receiving a transplant was studied (Cox proportional hazards model).
Results: Laboratory-dependent significant differences in MELD score were
demonstrated. Cox proportional hazards model showed a significant association
between MELD score and the probability of organ allocation. The
unadjusted hazard ratio for receiving a liver transplant was significantly
different between group 2 and group 4 (group 2: MELD 19–24; group 4:
MELD > 30).
Conclusion: Laboratory-dependent significant differences in MELD score
were observed between the six transplant centers. We demonstrated a significant
association between the MELD score and the probability of organ
allocation. The observed interlaboratory variation might yield a significant
difference in organ allocation in patients with high MELD scores.
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