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The Impact of the Introduction of MELD on the Dynamics of the Liver Transplantation Waiting List in São Paulo, Brazil.

Chaib E, Massad E, Varone BB, Bordini AL, Galvão FH, Crescenzi A, Filho AB, D'Albuquerque LA - J Transplant (2014)

Bottom Line: Our aim was to compare the waitlist dynamics before MELD (1997-2005) and after MELD (2006-2012) in our state.The number of transplantations from 1997 to 2005 and from 2006 to 2012 increased nonlinearly, with a clear trend to levelling to equilibrium at approximately 350 and 500 cases per year, respectively.Additionally, there was a significant effect on the waitlist dynamics in the first 4 years; however, the curves diverge from there, implying a long-range effect on the waitlist by the MELD scores.

View Article: PubMed Central - PubMed

Affiliation: Division of Liver Transplantation, LIM 37, Department of Gastroenterology, São Paulo School of Medicine, Suite 3206, 3rd Foor, 01246-903 São Paulo, SP, Brazil.

ABSTRACT
Until July 15, 2006, the time on the waiting list was the main criterion for allocating deceased donor livers in the state of São Paulo, Brazil. After this date, MELD has been the basis for the allocation of deceased donor livers for adult transplantation. Our aim was to compare the waitlist dynamics before MELD (1997-2005) and after MELD (2006-2012) in our state. A retrospective study was conducted including the data from all the liver transplant candidate waiting lists from July 1997 to December 2012. The data were related to the actual number of liver transplantations (Tr), the incidence of new patients on the list (I), and the number of patients who died while being on the waitlist (D) from 1997 to 2005 (the pre-MELD era) and from 2006 to 2012 (the post-MELD era). The number of transplantations from 1997 to 2005 and from 2006 to 2012 increased nonlinearly, with a clear trend to levelling to equilibrium at approximately 350 and 500 cases per year, respectively. The implementation of the MELD score resulted in a shorter waiting time until liver transplantation. Additionally, there was a significant effect on the waitlist dynamics in the first 4 years; however, the curves diverge from there, implying a long-range effect on the waitlist by the MELD scores.

No MeSH data available.


Transplantation rate (proportion of those patients transplanted with respect to those who enter the waiting list per time unit), comparing the pre- and post-MELD periods.
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Related In: Results  -  Collection


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fig4: Transplantation rate (proportion of those patients transplanted with respect to those who enter the waiting list per time unit), comparing the pre- and post-MELD periods.

Mentions: Additionally, we calculated the net transplantation rate, defined as the number of patients who received a graft among all the patients on the waiting list per time unit before and after the introduction of the MELD score. This calculation was performed by dividing the variables Tr by I from Table 2. The result is shown in Figure 4. The transplantation rate decreased until 2005, increased dramatically thereafter, and peaked at approximately 50% in 2009/2010, dropping from there onwards.


The Impact of the Introduction of MELD on the Dynamics of the Liver Transplantation Waiting List in São Paulo, Brazil.

Chaib E, Massad E, Varone BB, Bordini AL, Galvão FH, Crescenzi A, Filho AB, D'Albuquerque LA - J Transplant (2014)

Transplantation rate (proportion of those patients transplanted with respect to those who enter the waiting list per time unit), comparing the pre- and post-MELD periods.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4265688&req=5

fig4: Transplantation rate (proportion of those patients transplanted with respect to those who enter the waiting list per time unit), comparing the pre- and post-MELD periods.
Mentions: Additionally, we calculated the net transplantation rate, defined as the number of patients who received a graft among all the patients on the waiting list per time unit before and after the introduction of the MELD score. This calculation was performed by dividing the variables Tr by I from Table 2. The result is shown in Figure 4. The transplantation rate decreased until 2005, increased dramatically thereafter, and peaked at approximately 50% in 2009/2010, dropping from there onwards.

Bottom Line: Our aim was to compare the waitlist dynamics before MELD (1997-2005) and after MELD (2006-2012) in our state.The number of transplantations from 1997 to 2005 and from 2006 to 2012 increased nonlinearly, with a clear trend to levelling to equilibrium at approximately 350 and 500 cases per year, respectively.Additionally, there was a significant effect on the waitlist dynamics in the first 4 years; however, the curves diverge from there, implying a long-range effect on the waitlist by the MELD scores.

View Article: PubMed Central - PubMed

Affiliation: Division of Liver Transplantation, LIM 37, Department of Gastroenterology, São Paulo School of Medicine, Suite 3206, 3rd Foor, 01246-903 São Paulo, SP, Brazil.

ABSTRACT
Until July 15, 2006, the time on the waiting list was the main criterion for allocating deceased donor livers in the state of São Paulo, Brazil. After this date, MELD has been the basis for the allocation of deceased donor livers for adult transplantation. Our aim was to compare the waitlist dynamics before MELD (1997-2005) and after MELD (2006-2012) in our state. A retrospective study was conducted including the data from all the liver transplant candidate waiting lists from July 1997 to December 2012. The data were related to the actual number of liver transplantations (Tr), the incidence of new patients on the list (I), and the number of patients who died while being on the waitlist (D) from 1997 to 2005 (the pre-MELD era) and from 2006 to 2012 (the post-MELD era). The number of transplantations from 1997 to 2005 and from 2006 to 2012 increased nonlinearly, with a clear trend to levelling to equilibrium at approximately 350 and 500 cases per year, respectively. The implementation of the MELD score resulted in a shorter waiting time until liver transplantation. Additionally, there was a significant effect on the waitlist dynamics in the first 4 years; however, the curves diverge from there, implying a long-range effect on the waitlist by the MELD scores.

No MeSH data available.