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New findings from B.H. Ferraz and co-authors describe advances in cirrhosis

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"Preliminary results have indicated a reduction in waiting list deaths and an increase in transplantation rates for candidates. Seeking to find a new model to predict death on the waiting list and after liver transplantation, retrospective studies have examined MELD scores in waiting list patients. The aim of this study was to analyze the MELD scores of patients on the liver waiting list for comparisons between transplanted patients. A retrospective study was performed analyzing 131 registrations of 127 orthotopic liver transplant (OLT) patients (4 underwent retransplantation) grafted between November 2000 and January 2006, excluding 24 patients: 2 had urgent retransplantations due to hepatic artery thrombosis and 22 had incomplete data. These patients were divided into 3 groups: group I (transplanted patients)-53 patients underwent 55 OLT; group II-29 patients who died on the waiting list; group III-patients on the waiting list including 23 patients still waiting as of the date of the study. The main indication for OLT was hepatitis C virus cirrhosis (50.50%), followed by alcoholic liver cirrhosis (23.30%), cryptogenic cirrhosis (12.60%), autoimmune hepatitis (5.80%), hepatitis B virus cirrhosis (4.85%), and primary biliary cirrhosis (2.91%). Group I: MELD score 15.62 (range, 6-39) on admission to the list, and 18.87 (range, 7-39) at transplantation. The mean waiting time for OLT. was 478.39 days (range, 2-1270 days). The 38 patients who survived underwent 39 OLT (1 retransplantation). The MELD score at entrance to the list was 14.62 (range, 7-30) and at transplantation, 17.70 (range, 7-39). The mean time between admission to the list and transplantation was 505.37 days (range, 6-1270 days). The 15 patients who died had received 16 OLT (1 retransplantation). Their MELD scores were 17.80 (range, 6-39) and 21.81 (range, 9-39) at admission to the list and at transplantation, respectively, with a mean time on the waiting list of 417.93 days (range, 2-872 days). Group II: 29 patients died before OLT, at a mean age of 52.60 years (range, 22-67 years). Their MELD score was 19.24 (range, 7-45), and the interval between admission to the waiting list and death was 249.55 days (range, 3-1247 days). Group III: 23 patients still active on the OLT waiting list at the time of study displayed a mean MELD score of 13.65 (range, 6-28) and 354.30 days (range, 2-905 days) waiting until the moment," wrote B.H. Ferraz and colleagues.

The researchers concluded: "MELD score at the time of admission to the waiting list was higher among those patients who died either awaiting a liver graft (19.24) or after OLT (17.80) compared with those who survived after OLT (14.60) or ar'."

Ferraz and colleagues published their study in Transplantation Proceedings (Analysis of Model for End-Stage Liver Disease (MELD) score in a liver transplantation waiting list. Transplantation Proceedings, 2007;39(8):2511-2513).

For more information, contact B.H. Ferraz, Albert Einstein Jewish Hospital, Liver Tranaplantat Team, Off 389 Bloco B, Av Albert Einstein 627-701, BR-05652900 Sao Paulo, SP, Brazil.

Publisher contact information for the journal Transplantation Proceedings is: Elsevier Science Inc., 360 Park Avenue South, New York, NY 10010-1710, USA.

Keywords: Brazil, Sao Paulo, Addiction Medicine, Alcoholic Liver Cirrhosis, Alcoholism, Angiology, Bioengineering, Biomedical Engineering, Biomedicine, Fibrosis, Gastroenterology, HCV, Hepatic Artery, Hepatitis C Virus, Hepatology, Infectious Disease, Liver Cirrhosis, Liver Disease, Liver Transplant, Mental Health, Organ Transplant, Portosystemic, Thrombosis, Transplantation, Virology.

This article was prepared by Hepatitis Weekly editors from staff and other reports. Copyright 2008, Hepatitis Weekly via NewsRx.com.