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Title: The influence of laboratory-induced MELD score differences on liver allocation: more reality than myth
Authors: Schouten, J N ×
Francque, S
Van Vlierberghe, H
Colle, Ines
Nevens, Frederik
Delwaide, J
Adler, M
Starkel, P
Ysebaert, D
Gadisseur, A
De Winter, Bart
Smits, J M
Rahmel, A
Michielsen, Paul #
Issue Date: Jan-2012
Publisher: Wiley-Blackwell Publishing, Inc.
Series Title: Clinical Transplantation vol:26 issue:1 pages:E62-E70
Article number: 10.1111/j.1399-0012.2011.01538.x
Abstract: Schouten JN, Francque S, Van Vlierberghe H, Colle I, Nevens F, Delwaide J, Adler M, Starkel P, Ysebaert D, Gadisseur A, De Winter B, Smits JM, Rahmel A, Michielsen P. The influence of laboratory-induced MELD score differences on liver allocation: more reality than myth. Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01538.x. © 2011 John Wiley & Sons A/S. Abstract:  Background:  Liver allocation in Eurotransplant (ET) is based on the MELD score. Interlaboratory MELD score differences in INR and creatinine determination have been reported. The clinical implication of this observation has not been demonstrated. Methods:  MELD scores were calculated in 66 patients with liver cirrhosis using bilirubin, creatinine, and INR analyzed in six liver transplant centers. Based on allocation results of ET, patients transplanted from December 2006 to June 2007 were divided according to MELD score in four groups. For each group, the influence of the match MELD on the probability of receiving a transplant was studied (Cox proportional hazards model). Results:  Laboratory-dependent significant differences in MELD score were demonstrated. Cox proportional hazards model showed a significant association between MELD score and the probability of organ allocation. The unadjusted hazard ratio for receiving a liver transplant was significantly different between group 2 and group 4 (group 2: MELD 19-24; group 4: MELD > 30). Conclusion:  Laboratory-dependent significant differences in MELD score were observed between the six transplant centers. We demonstrated a significant association between the MELD score and the probability of organ allocation. The observed interlaboratory variation might yield a significant difference in organ allocation in patients with high MELD scores.
ISSN: 0902-0063
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hepatology
Centre for Food and Microbial Technology
× corresponding author
# (joint) last author

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