Experience Since MELD Implementation: How Does the New System Deliver?

Because of increasing waiting-list mortality, the MELD (Model for End-Stage Liver Disease) allocation system was implemented within most countries of the Eurotransplant area on December 16, 2006. Five years have now passed, and we review in this paper the effects of the MELD-based allocation upon th...

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Main Authors: Markus Quante, Christoph Benckert, Armin Thelen, Sven Jonas
Format: Article
Language:English
Published: Hindawi Limited 2012-01-01
Series:International Journal of Hepatology
Online Access:http://dx.doi.org/10.1155/2012/264015
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spelling doaj-f0355166e1ab42edadefcfdf9a4f10a02020-11-24T22:39:59ZengHindawi LimitedInternational Journal of Hepatology2090-34482090-34562012-01-01201210.1155/2012/264015264015Experience Since MELD Implementation: How Does the New System Deliver?Markus Quante0Christoph Benckert1Armin Thelen2Sven Jonas3Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyDepartment of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyDepartment of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyDepartment of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyBecause of increasing waiting-list mortality, the MELD (Model for End-Stage Liver Disease) allocation system was implemented within most countries of the Eurotransplant area on December 16, 2006. Five years have now passed, and we review in this paper the effects of the MELD-based allocation upon the waiting list for liver transplantation, on peri-operative management and on postoperative outcome. Giving priority to sicker patients on the waiting list has resulted in a significant increase in mean MELD score at the time of organ allocation. Consequently, there has also been a significant reduction in waiting-list mortality. However, in Germany a worsening in postoperative outcome, mainly in the group of high-MELD recipients (30 points), has been reported. This paper presents comprehensive results following liver transplantation within the MELD era. Especially for the group of high-risk recipients, risk factors for impaired survival are presented and discussed.http://dx.doi.org/10.1155/2012/264015
collection DOAJ
language English
format Article
sources DOAJ
author Markus Quante
Christoph Benckert
Armin Thelen
Sven Jonas
spellingShingle Markus Quante
Christoph Benckert
Armin Thelen
Sven Jonas
Experience Since MELD Implementation: How Does the New System Deliver?
International Journal of Hepatology
author_facet Markus Quante
Christoph Benckert
Armin Thelen
Sven Jonas
author_sort Markus Quante
title Experience Since MELD Implementation: How Does the New System Deliver?
title_short Experience Since MELD Implementation: How Does the New System Deliver?
title_full Experience Since MELD Implementation: How Does the New System Deliver?
title_fullStr Experience Since MELD Implementation: How Does the New System Deliver?
title_full_unstemmed Experience Since MELD Implementation: How Does the New System Deliver?
title_sort experience since meld implementation: how does the new system deliver?
publisher Hindawi Limited
series International Journal of Hepatology
issn 2090-3448
2090-3456
publishDate 2012-01-01
description Because of increasing waiting-list mortality, the MELD (Model for End-Stage Liver Disease) allocation system was implemented within most countries of the Eurotransplant area on December 16, 2006. Five years have now passed, and we review in this paper the effects of the MELD-based allocation upon the waiting list for liver transplantation, on peri-operative management and on postoperative outcome. Giving priority to sicker patients on the waiting list has resulted in a significant increase in mean MELD score at the time of organ allocation. Consequently, there has also been a significant reduction in waiting-list mortality. However, in Germany a worsening in postoperative outcome, mainly in the group of high-MELD recipients (30 points), has been reported. This paper presents comprehensive results following liver transplantation within the MELD era. Especially for the group of high-risk recipients, risk factors for impaired survival are presented and discussed.
url http://dx.doi.org/10.1155/2012/264015
work_keys_str_mv AT markusquante experiencesincemeldimplementationhowdoesthenewsystemdeliver
AT christophbenckert experiencesincemeldimplementationhowdoesthenewsystemdeliver
AT arminthelen experiencesincemeldimplementationhowdoesthenewsystemdeliver
AT svenjonas experiencesincemeldimplementationhowdoesthenewsystemdeliver
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