Assessment of reproducibility of creatinine measurement and MELD scoring in four liver transplant units in the UK
| Autor: | Carol Goulding, Liesl Smith, Neville V. Jamieson, David Mc Clure, Derek Manas, Simon Walker, Ingela Oberg, Devi Nair, David Patch, Andrew Kerry, Murat Akyol, Andrew K. Burroughs, Evangelous Cholongitas, David Cartwright |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Waiting Lists medicine.medical_treatment Liver transplantation Kidney Severity of Illness Index Liver disease chemistry.chemical_compound Internal medicine medicine Humans Bland–Altman plot Aged Transplantation Creatinine Models Statistical business.industry Liver Diseases Reproducibility of Results Bilirubin Middle Aged medicine.disease United Kingdom Surgery Liver Transplantation body regions chemistry Nephrology Creatinine Measurement Female Hemodialysis business Ireland Kidney disease |
| Zdroj: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 25(3) |
| ISSN: | 1460-2385 |
| Popis: | UNLABELLED: The Model for End-Stage Liver Disease (MELD) or similar scoring system is proposed in the UK for prioritization for liver transplantation. We evaluated the reproducibility of creatinine measurements and therefore MELD scores in four liver transplant units in the UK. METHODS: All transplant units were invited to participate; four agreed to do so, contributing 36 patients awaiting liver transplantation. Blood was collected from these 36 and divided into aliquots then sent to the four participating centres. Every centre measured creatinine and bilirubin for every patient. The results were analysed for the degree of agreement between centres for creatinine and MELD scores using the Bland-Altman method and Wilcoxon rank test. RESULTS: The mean creatinine value varied from 101 mumol/l in centre C to 110 micromol/l for the same sample in centre A, with significant differences between the four centres (P < 0.05, Wilcoxon signed-rank test). The MELD scores were significantly different between centre C and all other centres (P < 0.05). CONCLUSION: This study demonstrates lack of agreement in measurement of serum creatinine and MELD scoring between four UK transplant centres. A difference in two MELD points can have a significant impact on patient outcome, and these factors will have to be addressed if a UK-wide transplant list is to be initiated. |
| Databáze: | OpenAIRE |
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