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Waitlist Outcomes in Liver Transplant Candidates with High MELD and Severe Hepatic Encephalopathy DIGESTIVE DISEASES AND SCIENCES Gadiparthi, C., Cholankeril, G., Yoo, E. R., Hu, M., Wong, R. J., Ahmed, A. 2018; 63 (6): 1647–53

Abstract

Organ Procurement and Transplantation Network and United Network for Organ Sharing (OPTN/UNOS) implemented the Share 35 policy in June 2013 to prioritize the sickest patients awaiting liver transplantation (LT). However, Model for End-Stage Liver Disease (MELD) score does not incorporate hepatic encephalopathy (HE), an independent predictor of waitlist mortality.To evaluate the impact of severe HE (grade 3-4) on waitlist outcomes in MELD?=?30 patients.Using the OPTN/UNOS database, we evaluated LT waitlist registrants from 2005-2014. Demographics, comorbidities, and waitlist survival were compared between four cohorts: MELD 30-34 with severe HE, MELD 30-34 without severe HE, MELD?=?35 with severe HE, and MELD?=?35 without severe HE.Among 10,003 waitlist registrants studied, 41.6% had MELD score 30-34 and 58.4% had MELD?=?35. Patients with severe HE had a higher 90-day waitlist mortality in both MELD 30-34 (severe HE 71.1% vs. no HE 56.6%; p?

View details for PubMedID 29611079