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New Factor May Affect Waitlisted Liver Transplant Patients

Serum sodium concentration may help predict three-month survival for patients on waiting list

WEDNESDAY, Sept. 3 (HealthDay News) -- Adding an additional factor to the score currently used to determine allocation for liver transplants better predicts survival at three months for patients on the waiting list, according to a report in the Sept. 4 issue of the New England Journal of Medicine.

W. Ray Kim, M.D., from the Mayo Clinic College of Medicine in Rochester, Minn., and colleagues developed a survival model for 6,769 adult candidates for primary liver transplantation who were registered with the Organ Procurement and Transplantation Network in 2005-2006. Of these, 1,781 underwent a liver transplant and 422 died within 90 days of registration on the waiting list.

The researchers found that the Model for End-Stage Liver Disease (MELD) score, which takes into account serum bilirubin and creatinine levels and prothrombin time and is currently used to determine priority for liver allocation, combined with the serum sodium concentration was significantly associated with mortality within 90 days of registration. Applying this model to data for 2006, the MELD score plus serum sodium was much higher than the MELD score alone in 7 percent of the 477 patients who died.

"This population-wide study shows that the MELD score and the serum sodium concentration are important predictors of survival among candidates for liver transplantation," Kim and colleagues conclude.

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