1/17/2024 0 Comments Optn meld scoreScores can range anywhere from 6-40, and are based on results of several lab tests. 3 The MELD score, as previously mentioned, helps clinicians determine how urgently a patient needs a liver transplant. This is a prognostic scoring system based on specific laboratory measurements, used to predict 3-month mortality due to liver disease in patients 12 years of age and older. The MELD score stands for “Model for End-Stage Liver Disease”. One of the many factors that gets taken into consideration when determining which patients are in more urgent need of a liver transplant is the MELD score. 2 Despite these impressive numbers, there are a significantly larger number of patients still in need of a liver transplant who are currently on a waiting list. These numbers are similar to data provided from 2020 which showed that a total of 8,906 liver transplants occurred. 1 According to UNOS, 8,494 livers were transplanted in 2021. The United Network for Organ Sharing (UNOS) is a mission-driven non-profit that leads the network of transplant hospitals, organ procurement organizations, and thousands of volunteers who are dedicated to saving lives through organ transplants. The liver is one of the most commonly transplanted solid organs in the United States (US) today. Finally, the effects of the MELDNa score on race or genetic ancestry were not assessed.By: Jason Ifeanyi, PharmD Candidate c/o 2022 Also, because lab tests were not uniformly ordered, diagnostic bias could have affected the sample. Study limitations included the fact that listing and delisting dates were unavailable. Individuals with liver cancer or on dialysis were excluded. Across the entire cohort, the median age was 44 years and 57.7% were women. Most of the participants were healthy controls (n=598,409), while 601 were liver transplant patients and 24,921 had chronic liver disease but did not undergo transplant. Replication analyses were performed at the multisite NIH All of Us Research Program. "Previous studies ascribed sex differences in MELDNa scores to known sex differences in creatinine levels, but creatinine does not fully account for the sex difference in MELDNa scores," wrote Davis and colleagues.įor their study, the researchers examined EHR data on 623,931 individuals who received care at the Vanderbilt University Medical Center (VUMC) from March 2019 to April 2020. The simulated sex-adjusted model also showed a moderate reduction in deaths at 1 year compared to the OPTN model (2,480 vs 2,493), which "suggested that the sex-adjusted scores could help save lives," the researchers noted. In a proposed, sex-adjusted MELDNa scoring allocation model, slightly more women would have received a liver transplant than men (24.1% vs 23.1%) under the Organ Procurement and Transplantation Network (OPTN) MELDNa scoring, more men received transplants (23.7% vs 23.0%). "All laboratory traits used in the calculation of MELDNa scores show sex differences that increase male individuals' scores compared with female individuals', despite female individuals showing greater liver decompensation," the group concluded. Women who underwent liver transplants had more decompensation traits (mean 1.60 vs 1.34), even though they had lower MELDNa scores before transplantation (mean 20.21 vs 21.72, P=0.005 for both). And the pattern persisted regardless of whether patients were undergoing a liver transplant, had liver disease without undergoing transplant, or were healthy, according to Lea Davis, PhD, of the Vanderbilt Genetics Institute in Nashville, Tennessee, and colleagues, writing in JAMA Surgery.
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