Female liver transplant recipients with the same GFR as male recipients have lower MELD scores--a systematic bias
| Autor: | Michael B. Thomas, David Patch, Devaki Nair, Laura Marelli, Andrew Kerry, A.K. Burroughs, D. Goodier, Evangelos Cholongitas |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Waiting Lists medicine.medical_treatment Urology Renal function Liver transplantation Kidney Function Tests Models Biological Severity of Illness Index Liver disease chemistry.chemical_compound Sex Factors Bias Sex factors Internal medicine Severity of illness Immunology and Allergy Medicine Humans Pharmacology (medical) Aged Aged 80 and over Transplantation Creatinine business.industry Middle Aged medicine.disease Liver Transplantation Endocrinology chemistry Female business Mdrd formula Liver Failure Glomerular Filtration Rate |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 7(3) |
| ISSN: | 1600-6135 |
| Popis: | Women have lower glomerular filtration (GFR) than men for the same serum creatinine (Cr) value, not accounted for in model for end-stage liver disease (MELD). We compare male/female Cr, GFR (using MDRD formula) and respective MELD scores in 403 Cr measurements using standard (sCr), O'Leary modified (mCr) and Compensated (cCr) Jaffe and Enzymatic (eCr) in 158 liver disease patients, mCr in 208 liver transplantation (LT) candidates, and EDTA-Cr(51)-GFR in 38 other candidates for LT; considering each female as male, a 'corrected' Cr was derived. MELD scores were calculated for measured and "corrected" Cr in females. Median Cr and GFR in females were lower than males (p0.05). Both MDRD and EDTA-Cr(51) GFR were lower in females than males, despite lower Cr values. In females, each MELD score was lower than the corresponding MELD-corrected Cr (p0.001) withor =three-point difference in liver disease patients: 25%[sCr]; 23%[mCr]; 11%[eCr]; and 14%[cCr]. In 65% of female LT candidates, two- or three-point difference was found. Females with liver disease have lower GFR than males for the same Cr value; correcting Cr increases MELD score by two or three points in 65% of female LT candidates. MELD score adjustment in females would ensure equal LT priority by gender. |
| Databáze: | OpenAIRE |
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