The Effect of MELD Sodium Scoring System on Waiting List

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Abstract

Aim

In Turkey, cadaveric liver distribution is arranged by Health Ministry. During this distribution process a proposal list for 5 people is presented. Waiting lists have been arranged according to MELD sodium scoring system rather than MELD scoring system since 2016. The aim of this study is to investigate the effect of MELD sodium points to the waiting lists before June.

Method

In this study 50 cadaveric liver transplantation lists before 2016 June were retrospectively investigated. Proposal lists (250 patients totally) were rearranged by adding sodium levels to the MELD scores of patients. Two groups including patients with HCC (they can rise to the top of the list with additional points) and without HCC were formed. Changes in the order and in transplanted patients were analyzed.

Results

34% (n = 17) of patients were female and 66% (n = 33) were male. 64% of patients was getting higher points according to the old scoring system. In 28 proposal lists (56%), the order of patients were found to be affected by MELD sodium Points. Besides, in the 42% (21 lists) of proposal lists patients who will undergo liver transplantation, was altered by addition of MELD sodium scores. Among all lists in 68% of patients (34 patients) the diagnosis was HCC. Liver transplantation because of HCC was performed in 16 of patients. When patients with the diagnosis of HCC was omitted from the list the effect of MELD sodium score on the ratio of patients who will undergo liver transplantation was observed to be 46% (23 patients).

Conclusion

By using MELD sodium scoring system in nearly 50% of patients who will undergo transplantation was found to be altered.

Conclusion

References:

Conclusion

1. Machicao V, Model for End-Stage Liver Disease-Sodium Score: The Evolution in the Prioritization of Liver Transplantation.Clin Liver Dis.2017 May;21(2):275–287.

Conclusion

2. Federico Pinero, Sicker Patients for Liver Transplantation: Meld, Meld Sodium, and Integrated Meld’s Prognostic Accuracy in the Assessment of Posttransplantation Events at a Single Center from Argentina.Hindawi Publishing Corporation ISRN Transplantation Volume 2013, Article ID 102590.

Conclusion

3. B. C. Yun, Impact of pretransplant hyponatremia on outcome following liver transplantation, Hepatology, vol. 49, no. 5, pp. 1610–1615, 2009.

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