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The influence of laboratory-induced MELD score differences on liver allocation: more reality than myth

JN Schouten, S Francque, Hans Van Vlierberghe UGent, Isabelle Colle UGent, F Nevens, J Delwaide, M Adler, P Starkel, D Ysebaert and A Gadisseur, et al. (2012) CLINICAL TRANSPLANTATION. 26(1). p.E62-E70
abstract
Background: Liver allocation in Eurotransplant (ET) is based on the MELD score. Interlaboratory MELD score differences in INR and creatinine determination have been reported. The clinical implication of this observation has not been demonstrated. Methods: MELD scores were calculated in 66 patients with liver cirrhosis using bilirubin, creatinine, and INR analyzed in six liver transplant centers. Based on allocation results of ET, patients transplanted from December 2006 to June 2007 were divided according to MELD score in four groups. For each group, the influence of the match MELD on the probability of receiving a transplant was studied (Cox proportional hazards model). Results: Laboratory-dependent significant differences in MELD score were demonstrated. Cox proportional hazards model showed a significant association between MELD score and the probability of organ allocation. The unadjusted hazard ratio for receiving a liver transplant was significantly different between group 2 and group 4 (group 2: MELD 19-24; group 4: MELD > 30). Conclusion: Laboratory-dependent significant differences in MELD score were observed between the six transplant centers. We demonstrated a significant association between the MELD score and the probability of organ allocation. The observed interlaboratory variation might yield a significant difference in organ allocation in patients with high MELD scores
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
bilirubin, creatinine, allocation, international normalized ratio, liver transplantation, MELD score, INTERNATIONAL NORMALIZED RATIO, DISEASE MELD, PROTHROMBIN TIME, CIRRHOSIS INRLIVER, WAITING-LIST, MODEL, TRANSPLANTATION, SURVIVAL, VARIABILITY, PROGNOSIS
journal title
CLINICAL TRANSPLANTATION
Clin. Transplant.
volume
26
issue
1
pages
E62 - E70
Web of Science type
Article
Web of Science id
000300715100010
JCR category
SURGERY
JCR impact factor
1.634 (2012)
JCR rank
73/195 (2012)
JCR quartile
2 (2012)
ISSN
0902-0063
DOI
10.1111/j.1399-0012.2011.01538.x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2077371
handle
http://hdl.handle.net/1854/LU-2077371
date created
2012-03-30 07:43:31
date last changed
2012-04-12 11:14:19
@article{2077371,
  abstract     = {Background: Liver allocation in Eurotransplant (ET) is based on the MELD score. Interlaboratory MELD score differences in INR and creatinine determination have been reported. The clinical implication of this observation has not been demonstrated. 
Methods: MELD scores were calculated in 66 patients with liver cirrhosis using bilirubin, creatinine, and INR analyzed in six liver transplant centers. Based on allocation results of ET, patients transplanted from December 2006 to June 2007 were divided according to MELD score in four groups. For each group, the influence of the match MELD on the probability of receiving a transplant was studied (Cox proportional hazards model). 
Results: Laboratory-dependent significant differences in MELD score were demonstrated. Cox proportional hazards model showed a significant association between MELD score and the probability of organ allocation. The unadjusted hazard ratio for receiving a liver transplant was significantly different between group 2 and group 4 (group 2: MELD 19-24; group 4: MELD {\textrangle} 30). 
Conclusion: Laboratory-dependent significant differences in MELD score were observed between the six transplant centers. We demonstrated a significant association between the MELD score and the probability of organ allocation. The observed interlaboratory variation might yield a significant difference in organ allocation in patients with high MELD scores},
  author       = {Schouten, JN and Francque, S and Van Vlierberghe, Hans and Colle, Isabelle and Nevens, F and Delwaide, J and Adler, M and Starkel, P and Ysebaert, D and Gadisseur, A and De Winter, B and Smits, JM and Rahmel, A and Michielsen, P},
  issn         = {0902-0063},
  journal      = {CLINICAL TRANSPLANTATION},
  keyword      = {bilirubin,creatinine,allocation,international normalized ratio,liver transplantation,MELD score,INTERNATIONAL NORMALIZED RATIO,DISEASE MELD,PROTHROMBIN TIME,CIRRHOSIS INRLIVER,WAITING-LIST,MODEL,TRANSPLANTATION,SURVIVAL,VARIABILITY,PROGNOSIS},
  language     = {eng},
  number       = {1},
  pages        = {E62--E70},
  title        = {The influence of laboratory-induced MELD score differences on liver allocation: more reality than myth},
  url          = {http://dx.doi.org/10.1111/j.1399-0012.2011.01538.x},
  volume       = {26},
  year         = {2012},
}

Chicago
Schouten, JN, S Francque, Hans Van Vlierberghe, Isabelle Colle, F Nevens, J Delwaide, M Adler, et al. 2012. “The Influence of Laboratory-induced MELD Score Differences on Liver Allocation: More Reality Than Myth.” Clinical Transplantation 26 (1): E62–E70.
APA
Schouten, J., Francque, S., Van Vlierberghe, H., Colle, I., Nevens, F., Delwaide, J., Adler, M., et al. (2012). The influence of laboratory-induced MELD score differences on liver allocation: more reality than myth. CLINICAL TRANSPLANTATION, 26(1), E62–E70.
Vancouver
1.
Schouten J, Francque S, Van Vlierberghe H, Colle I, Nevens F, Delwaide J, et al. The influence of laboratory-induced MELD score differences on liver allocation: more reality than myth. CLINICAL TRANSPLANTATION. 2012;26(1):E62–E70.
MLA
Schouten, JN, S Francque, Hans Van Vlierberghe, et al. “The Influence of Laboratory-induced MELD Score Differences on Liver Allocation: More Reality Than Myth.” CLINICAL TRANSPLANTATION 26.1 (2012): E62–E70. Print.