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
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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