1. Does the meld system provide equal access to liver transplantation for patients with different ABO blood groups?
- Author
-
IJtsma AJ, van der Hilst CS, Nijkamp DM, Bottema JT, Fidler V, Porte RJ, and Slooff MJ
- Subjects
- Adolescent, Adult, Algorithms, Child, Female, Humans, Liver Failure mortality, Liver Transplantation mortality, Male, Middle Aged, Multivariate Analysis, Netherlands, Probability, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Waiting Lists, ABO Blood-Group System, Health Services Accessibility, Liver surgery, Liver Failure surgery, Liver Transplantation methods
- Abstract
This study investigates the relationship between blood group and waiting time until transplantation or death on the waiting list. All patients listed for liver transplantation in the Netherlands between 15 December 2006 and 31 December 2012, were included. Study variables were gender, age, year of listing, diagnosis, previous transplantations, blood group, urgency, and MELD score. Using a competing risks analysis, separate cumulative incidence curves were constructed for death on the waiting list and transplantation and used to evaluate outcomes.In 517 listings, the mean death rate per 100 patient-years was 10.4. A total of 375 (72.5% of all listings) were transplanted. Of all transplantations, 352 (93.9%) were ABO-identical and 23 (6.1%) ABO-compatible. The 5-year cumulative incidence of death was 11.2% (SE 1.4%), and of transplantation 72.5% (SE 2.0%). Patient blood group had no multivariate significant impact on the hazard of dying on the waiting list nor on transplantation. Age, MELD score, and urgency status were significantly related to the death on the waiting list and transplantation. More recent listing had higher probability of being transplanted. In the MELD era, patient blood group status does not have a significant impact on liver transplant waiting list mortality nor on waiting time for transplantation., (© 2016 Steunstichting ESOT.)
- Published
- 2016
- Full Text
- View/download PDF