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Disease Severity Linked to Transplant Wait List Mortality

Researchers determine risk factors for liver transplantation waiting list mortality

THURSDAY, Jan. 18 (HealthDay News) -- Patients who are waiting for liver transplantation who have higher disease severity scores are less likely to survive until transplant than patients with lower scores, according to study findings published in the January issue of the Journal of Gastroenterology and Hepatology. In addition, the study found that women and those waiting for a second organ after the failure of a first transplant were at greater risk as well.

Michael A. Fink, and colleagues at the University of Melbourne in Victoria, Australia, examined risk factors in 551 patients on a liver transplant waiting list from 1988 through 2004 in the Liver Transplant Unit Victoria. During this period, the mean annual waiting list mortality was 10.6 percent in adults and 6.4 percent in children.

Factors associated with mortality were female gender, non-function of a primary transplant, fulminant hepatic failure, blood group O, a worse United Network for Organ Sharing (UNOS)-derived medical status, a high Child-Turcotte-Pugh (CTP) score (11 or greater), a high model for end-stage liver disease score (MELD of 20 or greater), and a high pediatric end-stage liver disease score (20 or greater).

Multivariate factors associated with waiting list mortality were UNOS-derived medical status, MELD score and CTP class, according to the study.

"Disease severity scores, such as MELD, predict the risk of liver transplantation waiting list mortality," Fink and colleagues conclude.

Abstract
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