MELD score does not discriminate against patients with hepatic encephalopathy. Dig Dis Sci 2005 Apr;50(4):753-6
Date
04/23/2005Pubmed ID
15844713DOI
10.1007/s10620-005-2568-yScopus ID
2-s2.0-17644428031 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
Hepatic encephalopathy (HE) is a significant complication of cirrhosis and part of the CTP score. The UNOS database was queried for listings from February 2001 to February 2002 (CTP era) and February 2002 to February 2003 (MELD era). HE at listing, Grade III/IV HE at transplant, and 12-month posttransplant survival were compared. HE rate at listing was similar, whereas Grade III/IV HE at time of transplant was significantly lower in the MELD era. Waiting periods were shorter in the MELD era. Twelve-month posttransplant survival was lower in all patients with HE at listing (P < 0.0001) and for patients with Grade III/IV HE at transplant (P < 0.0001) in both eras. No significant change in posttransplant survival of HE patients was observed after MELD implementation. We conclude that (1) HE patients have worse posttransplant survival even after MELD; (2) MELD allows more rapid transplantation; and (3) rates of HE at listing have not changed since MELD implementation; however, rates of Grade III/IV HE at transplant have decreased.
Author List
Bajaj JS, Saeian KAuthor
Kia Saeian MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Decision Support TechniquesHepatic Encephalopathy
Humans
Liver Transplantation
Postoperative Period
Severity of Illness Index
Survival Analysis
Time Factors
Waiting Lists