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.

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

scholarly journals RIPK3-Mediated Necroptosis and Neutrophil Infiltration Are Associated with Poor Prognosis in Patients with Alcoholic Cirrhosis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Zhenzhen Zhang ◽  
Guomin Xie ◽  
Li Liang ◽  
Hui Liu ◽  
Jing Pan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Poor Prognosis ◽  
Alcoholic Cirrhosis ◽  
Normal Liver ◽  
Neutrophil Infiltration ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
End Stage

Alcoholic cirrhosis is an end-stage liver disease with impaired survival and often requires liver transplantation. Recent data suggests that receptor-interacting protein kinase-3- (RIPK3-) mediated necroptosis plays an important role in alcoholic cirrhosis. Additionally, neutrophil infiltration is the most characteristic pathologic hallmark of alcoholic hepatitis. Whether RIPK3 level is correlated with neutrophil infiltration or poor prognosis in alcoholic cirrhotic patients is still unknown. We aimed to determine the correlation of RIPK3 and neutrophil infiltration with the prognosis in the end-stage alcoholic cirrhotic patients. A total of 20 alcoholic cirrhotic patients subjected to liver transplantation and 5 normal liver samples from control patients were retrospectively enrolled in this study. Neutrophil infiltration and necroptosis were assessed by immunohistochemical staining for myeloperoxidase (MPO) and RIPK3, respectively. The noninvasive score system (model for end-stage liver disease (MELD)) and histological score systems (Ishak, Knodell, and ALD grading and ALD stage) were used to evaluate the prognosis. Neutrophil infiltration was aggravated in patients with a high MELD score (≥32) in the liver. The MPO and RIPK3 levels in the liver were positively related to the Ishak score. The RIPK3 was also significantly and positively related to the Knodell score. In conclusion, RIPK3-mediated necroptosis and neutrophil-mediated alcoholic liver inflammatory response are highly correlated with poor prognosis in patients with end-stage alcoholic cirrhosis. RIPK3 and MPO might serve as potential predictors for poor prognosis in alcoholic cirrhotic patients.

Model for the end-stage liver disease and death prediction in a cohort of Brazilian patients on the waiting list for liver transplantation

2008 ◽  
Vol 22 (5) ◽  
pp. 651-656 ◽  
Author(s):  
Ajacio Brandão ◽  
Sandra C Fuchs ◽  
Ana L Gleisner ◽  
Claudio Marroni ◽  
Maria L Zanotelli ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals The use of MELD scores in critically ill cirrhotic patients

2016 ◽  
Vol 4 (16) ◽  
pp. 45
Author(s):  
Supannee Rassameehiran ◽  
Tinsay Woreta
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Hospital Mortality ◽  
Organ Failure ◽  
Critically Ill ◽  
Meld Score ◽  
Chronic Liver Failure ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
End Stage

The Model for End-Stage Liver Disease (MELD) was originally created to predict survival following transjugular intrahepatic portosystemic shunt and was subsequently found to accurately predict mortality in patients with end-stage liver disease. It has been used in the United States for liver allocation since 2002, and implementation of the MELD score resulted in a reduction in total number of deaths on the waitlist and a reduction in waiting time. Critically ill cirrhotic patients have an in-hospital mortality greater than 50%. Although the MELD score was also found to be an accurate predictor of in-ICU mortality and in-hospital mortality after ICU admission in critically ill cirrhotic patients, the Sequential Organ Failure Assessment (SOFA) score appears to perform better in many studies. The Chronic Liver Failure Consortium Acute-on-Chronic Liver Failure (CLIF-C ACLF) score was later developed by using specific cut-points for each organ failure score system in CLIF patients to predict mortality in patients with ACLF. Neither the MELD nor SOFA score independently predicts post-liver transplantation mortality in cirrhotic patients with extrahepatic organ failure and should not be use as a delisting criterion for these patients. More data are needed to determine the accuracy of the CLIF-C ACLF score in predicting post-liver transplantation outcomes. Prospective evaluation of critically ill cirrhotic patients is needed to optimize liver organ allocation.

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.

scholarly journals The von Willebrand Factor Facilitates Model for End‐Stage Liver Disease–Independent Risk Stratification on the Waiting List for Liver Transplantation

Hepatology ◽  
2020 ◽  
Vol 72 (2) ◽  
pp. 584-594 ◽  
Author(s):  
Georg P. Györi ◽  
David Pereyra ◽  
Benedikt Rumpf ◽  
Hubert Hackl ◽  
Christoph Köditz ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Risk Stratification ◽  
Von Willebrand Factor ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
End Stage ◽  
Von Willebrand ◽  
Willebrand Factor
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