Model for End-Stage Liver Disease (MELD) Score System to Evaluate Patients With Viral Hepatitis on the Waiting List: Better Than the Child-Turcotte-Pugh (CTP) System?

2008 ◽  
Vol 40 (6) ◽  
pp. 1906-1909 ◽  
Author(s):  
O. Cuomo ◽  
A. Perrella ◽  
G. Arenga
Keyword(s):  
Liver Disease ◽  
Viral Hepatitis ◽  
Meld Score ◽  
Waiting List ◽  
Score System ◽  
End Stage Liver Disease ◽  
End Stage ◽  
Better Than

scholarly journals Impact of Integrating Insulin-Like Growth Factor 1 Levels into Model for End-Stage Liver Disease Score for Survival Prediction in Hepatocellular Carcinoma Patients

Oncology ◽  
2020 ◽  
Vol 98 (12) ◽  
pp. 836-846
Author(s):  
Reham Abdel-Wahab ◽  
Manal M. Hassan ◽  
Bhawana George ◽  
Roberto Carmagnani Pestana ◽  
Lianchun Xiao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Growth Factor ◽  
Meld Score ◽  
Waiting List ◽  
Survival Prediction ◽  
Insulin Like Growth Factor ◽  
Priority Assignment ◽  
End Stage Liver Disease ◽  
End Stage

<b><i>Background:</i></b> Liver reserve affects survival in hepatocellular carcinoma (HCC). Model for End-Stage Liver Disease (MELD) score is used to predict overall survival (OS) and to prioritize HCC patients on the transplantation waiting list, but more accurate models are needed. We hypothesized that integrating insulin-like growth factor 1 (IGF-1) levels into MELD score (MELD-IGF-1) improves OS prediction as compared to MELD. <b><i>Methods:</i></b> We measured plasma IGF-1 levels in training (<i>n</i> = 310) and validation (<i>n</i> = 155) HCC cohorts and created MELD-IGF-1 score. Cox models were used to determine the association of MELD and MELD-IGF-1 with OS. Harrell’s c-index was used to compare the predictive capacity. <b><i>Results:</i></b> IGF-1 was significantly associated with OS in both cohorts. Patients with an IGF-1 level of ≤26 ng/mL in the training cohort and in the validation cohorts had significantly higher hazard ratios than patients with the same MELD but IGF-1 &#x3e;26 ng/mL. In both cohorts, MELD-IGF-1 scores had higher c-indices (0.60 and 0.66) than MELD scores (0.58 and 0.60) (<i>p</i> &#x3c; 0.001 in both cohorts). Overall, 26% of training and 52.9% of validation cohort patients were reclassified into different risk groups by MELD-IGF-1 (<i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> After independent validation, the MELD-IGF-1 could be used to risk-stratify patients in clinical trials and for priority assignment for patients on liver transplantation waiting list.

Analysis of Model for End-Stage Liver Disease (MELD) Score in a Liver Transplantation Waiting List

2007 ◽  
Vol 39 (8) ◽  
pp. 2511-2513 ◽  
Author(s):  
B.-H. Ferraz-Neto ◽  
R. Hidalgo ◽  
T. Thomé ◽  
V.A. Melo ◽  
A. Lobue ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Meld Score ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
End Stage

The Case of the Criminal Liver

2011 ◽  
Vol 20 (1) ◽  
pp. 143-143 ◽  
Author(s):  
RUCHIKA MISHRA
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Chinese American ◽  
Chronic Fatigue ◽  
Meld Score ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
Speed Up ◽  
End Stage

Mr. C was a 62-year-old Chinese-American man suffering from end stage liver disease secondary to Hepatitis C. While on the waiting list for a liver, he was told that his current condition and MELD score were not advanced enough to expect a liver transplant for several years. Because of his chronic fatigue, he asked if there was any way to speed up the process but was told that was not possible.

scholarly journals Liver transplantation: expectation with MELD score for liver allocation in Brazil

2006 ◽  
Vol 21 (suppl 1) ◽  
pp. 12-14 ◽  
Author(s):  
Andreza Correa Teixeira ◽  
Fernanda Fernandes Souza ◽  
Gustavo de Assis Mota ◽  
Ana de Lourdes Candolo Martinelli ◽  
Ajith Kumar Sankarankutty ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Meld Score ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
Liver Allocation ◽  
Number Of Patients ◽  
Severe Liver Disease ◽  
End Stage ◽  
New Criterion

Liver transplantation represents the most effective therapy for patients suffering from chronic end-stage liver disease. Until very recently, in Brazil, liver allocation was based on the Child-Turcotte-Pugh score and the waiting list followed a chronological criterion. In February 2002 the Model for End-stage Liver Disease (MELD) score was adopted for the allocation of donor livers in the US. After that change, an increased number of patients with more severe liver disease was observed, although there was no difference in 1-year patient and graft survival. A reduction in waiting-list mortality was also observed. In Brazil, the MELD score was adopted on May 31st, 2006. Good results are expected regarding the new criterion for allocation.

scholarly journals Validation of the Model of End-Stage Liver Disease for Liver Transplant Allocation in Alberta: Implications for Future Directions in Canada

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Kelly W. Burak ◽  
Glenda A. Meeberg ◽  
Robert P. Myers ◽  
Gordon H. Fick ◽  
Mark G. Swain ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Meld Score ◽  
Liver Transplants ◽  
Future Directions ◽  
End Stage Liver Disease ◽  
The Usa ◽  
End Stage ◽  
Waitlist Mortality ◽  
Better Than

Background. Since 2002, the Model of End-Stage Liver Disease (MELD) has been used for allocation of liver transplants (LT) in the USA. In Canada, livers were allocated by the CanWAIT algorithm. The aim of this study was to compare the abilities of MELD, Child-Pugh (CP), and CanWAIT status to predict 3-month and 1-year mortality before LT in Canadian patients and to describe the use of MELD in Canada.Methods. Validation of MELD was performed in 320 patients listed for LT in Alberta (1998–2002). In October 2014, a survey of MELD use by Canadian LT centers was conducted.Results. Within 1 year of listing, 47 patients were removed from the waiting list (29 deaths, 18 too ill for LT). Using logistic regression, the MELD and CP were better than the CanWAIT at predicting 3-month (AUROC: 0.79, 0.78, and 0.59;p=0.0002) and 1-year waitlist mortality (AUROC: 0.70, 0.70, and 0.55;p=0.0023). Beginning in 2004, MELD began to be adopted by Canadian LT programs but its use was not standardized.Conclusions. Compared with the CanWAIT system, the MELD score was significantly better at predicting LT waitlist mortality. MELD-sodium (MELD-Na) has now been adopted for LT allocation in Canada.

scholarly journals COVID-19 in liver transplant candidates: pretransplant and post-transplant outcomes - an ELITA/ELTR multicentre cohort study

Gut ◽  
2021 ◽  
pp. gutjnl-2021-324879
Author(s):  
Luca Saverio Belli ◽  
Christophe Duvoux ◽  
Paolo Angelo Cortesi ◽  
Rita Facchetti ◽  
Speranta Iacob ◽  
...  
Keyword(s):  
Liver Disease ◽  
Respiratory Failure ◽  
Meld Score ◽  
Decompensated Cirrhosis ◽  
Cox Regression Analysis ◽  
Post Transplant ◽  
End Stage Liver Disease ◽  
Significant Difference ◽  
End Stage ◽  
The Impact

ObjectiveExplore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course.DesignData from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed.ResultsFrom 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10–30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15–19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44–102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31–170).ConclusionsIncreased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).

scholarly journals Doppler ultrasound in liver cirrhosis: correlation of hepatic artery and portal vein measurements with model for end-stage liver disease score in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Rana Magdy Mohamed ◽  
Khaled Helmy El-kaffas
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Meld Score ◽  
Hepatic Decompensation ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
Us Findings ◽  
End Stage

Abstract Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.

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