MELD Scores of Liver Transplant Recipients According to Size of Waiting List
Trotter, James F.
Osgood, Michael J.
JAMA: The Journal of the American Medical Association 2004 April 21; 291(15): 1871-1874
CONTEXT: The Model for Endstage Liver Disease (MELD) score serves as the basis for the distribution of deceased-donor (DD) livers and was developed in response to "the final rule" mandate, whose stated principle is to allocate livers according to a patient's medical need, with less emphasis on keeping organs in the local procurement area. However, in selected areas of the United States, organs are kept in organ procurement organizations (OPOs) with small waiting lists and transplanted into less-sick patients instead of being allocated to sicker patients in nearby transplant centers in OPOs with large waiting lists. OBJECTIVE: To determine whether there is a difference in MELD scores for liver transplant recipients receiving transplants in small vs large OPOs. DESIGN AND SETTING: Retrospective review of the US Scientific Registry of Transplant Recipients between February 28, 2002, and March 31, 2003. Transplant recipients (N = 4798) had end-stage liver disease and received DD livers. MAIN OUTCOME MEASURES: MELD score distribution (range, 6-40), graft survival, and patient survival for liver transplant recipients in small (
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