Survival outcomes in liver transplant recipients with Model for End‐stage Liver Disease scores of 40 or higher: a decade‐long experience
Autor: | Jeromy Patterson, Jorge Ortiz, Eric Siskind, Farah Karipineni, Joel B. Durinka, Hina J. Panchal, Sarah Ashburn |
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Rok vydání: | 2015 |
Předmět: |
Male
Time Factors Databases Factual medicine.medical_treatment Kaplan-Meier Estimate Liver transplantation law.invention Liver disease Model for End-Stage Liver Disease Risk Factors law Survivors education.field_of_study Liver Diseases Gastroenterology Middle Aged Allografts Intensive care unit Treatment Outcome surgical procedures operative Female Adult medicine.medical_specialty Tissue and Organ Procurement Adolescent Population Decision Support Techniques Young Adult Predictive Value of Tests Internal medicine medicine Humans education Intensive care medicine Aged Proportional Hazards Models Retrospective Studies Chi-Square Distribution Hepatology business.industry Proportional hazards model Patient Selection Retrospective cohort study Original Articles medicine.disease Transplant Recipients United States Liver Transplantation body regions Multivariate Analysis business Chi-squared distribution |
Zdroj: | HPB. 17:1074-1084 |
ISSN: | 1365-182X |
Popis: | BackgroundThe Model for End‐stage Liver Disease (MELD) has been used as a prognostic tool since 2002 to predict pre‐transplant mortality. Increasing proportions of transplant candidates with higher MELD scores, combined with improvements in transplant outcomes, mandate the need to study surgical outcomes in patients with MELD scores of ≥40.MethodsA retrospective longitudinal analysis of United Network for Organ Sharing (UNOS) data on all liver transplantations performed between February 2002 and June 2011 (n= 33 398) stratified by MELD score (60 years, obesity, peri‐transplantation intensive care unit hospitalization with ventilation, and multiple comorbidities.ConclusionsLiver transplantation in recipients with MELD scores of ≥40 offers acceptable longterm survival outcomes. Futility predictors indicate the need for prospective follow‐up studies to define the population to gain the highest benefit from this precious resource. |
Databáze: | OpenAIRE |
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