MELD Score as a Prognostic Model for Listing Acute Liver Failure Patients for Liver Transplantation
The King’s College Hospital (KCH) criteria are widely used for listing patients with acute liver failure (ALF) for liver transplantation (LT). Recent reports have suggested that the Model for End-Stage Liver Disease (MELD) score may be useful in assessing prognosis in ALF (nonparacetamol). This stud...
Gespeichert in:
| Veröffentlicht in: | Transplantation proceedings 2006-09, Vol.38 (7), p.2097-2098 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2098 |
|---|---|
| container_issue | 7 |
| container_start_page | 2097 |
| container_title | Transplantation proceedings |
| container_volume | 38 |
| creator | Zaman, M.B. Hoti, E. Qasim, A. Maguire, D. McCormick, P.A. Hegarty, J.E. Geoghegan, J.G. Traynor, O. |
| description | The King’s College Hospital (KCH) criteria are widely used for listing patients with acute liver failure (ALF) for liver transplantation (LT). Recent reports have suggested that the Model for End-Stage Liver Disease (MELD) score may be useful in assessing prognosis in ALF (nonparacetamol). This study compares prognostic accuracy of the two systems in patients with paracetamol (POD)-induced ALF treated in this unit.
Seventy-two patients (average age 38 years; F:M ratio 2:1) admitted from 1994 to 2005 with POD-related ALF were studied. Clinical and biochemical parameters were recorded. The effect of applying a MELD score of greater than 30 as listing criteria for LT was calculated and compared with the KCH criteria. Outcomes were defined as LT, death, or full recovery.
Thirty-one patients (43%) recovered with medical therapy, 29 (40%) patients died, and 12 (17%) underwent LT. Sixty five percent of patients had a MELD > 30 and therefore could potentially be listed on admission; however, using KCH criteria only 24% patients were listed immediately. Sensitivity and negative predictive value of MELD was higher then KCH; however, we found KCH to have much higher specificity and positive predictive value.
MELD has higher sensitivity and negative predictive value for POD-induced ALF than the KCH criteria. However, the high false-positive rate associated with MELD limits its clinical utility. The high negative predictive value of MELD score may allow it to be used in conjunction with KCH criteria to avoid unneeded LT in patients who will likely recover spontaneously. |
| doi_str_mv | 10.1016/j.transproceed.2006.06.004 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68873187</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0041134506006221</els_id><sourcerecordid>68873187</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-b45cf37d1a2f8086bea1cc897785ff669e64505431347a51ce9085709d559b3e3</originalsourceid><addsrcrecordid>eNqNkN9LHDEQgEOx1OvpvyChYN_2THaTbNY38UcrnFRQn0NudlZy7G1skhX875vtLdbHwkDIzDeTyUfIN85WnHF1tl2lYIf4EjwgtquSMbWagolPZMF1XRWlKqsDssgZXvBKyEPyNcYty_dSVF_IIVeNZozzBYG76_UVfQAfkNpILb0P_nnwMTmgd77FnnY-0LXLieGZXsCYMN9eMdAb6_oxd93b5HBIcQan0uPf9Xo7pFzzwxH53Nk-4vF8LsnTzfXj5c9i_evH7eXFugBRi1RshISuqltuy04zrTZoOYBu6lrLrlOqQSUkk6LKP6qt5IAN07JmTStls6mwWpLv-7nZzO8RYzI7FwH7vAj6MRqls5vJz5Kc70EIPsaAnXkJbmfDm-HMTIrN1nxUbCbFZgomcvPJ_Mq42eXae-vsNAOnM2Aj2L7Lg8DFf5zmSjDZZO5qz2F28uowmAjZJGDrAkIyrXf_s88fqdGgcA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68873187</pqid></control><display><type>article</type><title>MELD Score as a Prognostic Model for Listing Acute Liver Failure Patients for Liver Transplantation</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Zaman, M.B. ; Hoti, E. ; Qasim, A. ; Maguire, D. ; McCormick, P.A. ; Hegarty, J.E. ; Geoghegan, J.G. ; Traynor, O.</creator><creatorcontrib>Zaman, M.B. ; Hoti, E. ; Qasim, A. ; Maguire, D. ; McCormick, P.A. ; Hegarty, J.E. ; Geoghegan, J.G. ; Traynor, O.</creatorcontrib><description>The King’s College Hospital (KCH) criteria are widely used for listing patients with acute liver failure (ALF) for liver transplantation (LT). Recent reports have suggested that the Model for End-Stage Liver Disease (MELD) score may be useful in assessing prognosis in ALF (nonparacetamol). This study compares prognostic accuracy of the two systems in patients with paracetamol (POD)-induced ALF treated in this unit.
Seventy-two patients (average age 38 years; F:M ratio 2:1) admitted from 1994 to 2005 with POD-related ALF were studied. Clinical and biochemical parameters were recorded. The effect of applying a MELD score of greater than 30 as listing criteria for LT was calculated and compared with the KCH criteria. Outcomes were defined as LT, death, or full recovery.
Thirty-one patients (43%) recovered with medical therapy, 29 (40%) patients died, and 12 (17%) underwent LT. Sixty five percent of patients had a MELD > 30 and therefore could potentially be listed on admission; however, using KCH criteria only 24% patients were listed immediately. Sensitivity and negative predictive value of MELD was higher then KCH; however, we found KCH to have much higher specificity and positive predictive value.
MELD has higher sensitivity and negative predictive value for POD-induced ALF than the KCH criteria. However, the high false-positive rate associated with MELD limits its clinical utility. The high negative predictive value of MELD score may allow it to be used in conjunction with KCH criteria to avoid unneeded LT in patients who will likely recover spontaneously.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2006.06.004</identifier><identifier>PMID: 16980011</identifier><identifier>CODEN: TRPPA8</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Bilirubin - blood ; Biological and medical sciences ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatic Encephalopathy - classification ; Hepatic Encephalopathy - mortality ; Hepatic Encephalopathy - surgery ; Humans ; International Normalized Ratio ; Liver Failure, Acute - classification ; Liver Failure, Acute - mortality ; Liver Failure, Acute - surgery ; Liver Failure, Acute - therapy ; Liver Transplantation - statistics & numerical data ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Other diseases. Semiology ; Patient Selection ; Prognosis ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Analysis ; Tissue, organ and graft immunology ; Treatment Outcome ; Waiting Lists</subject><ispartof>Transplantation proceedings, 2006-09, Vol.38 (7), p.2097-2098</ispartof><rights>2006 Elsevier Inc.</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-b45cf37d1a2f8086bea1cc897785ff669e64505431347a51ce9085709d559b3e3</citedby><cites>FETCH-LOGICAL-c474t-b45cf37d1a2f8086bea1cc897785ff669e64505431347a51ce9085709d559b3e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.transproceed.2006.06.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3550,23930,23931,25140,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18164059$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16980011$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zaman, M.B.</creatorcontrib><creatorcontrib>Hoti, E.</creatorcontrib><creatorcontrib>Qasim, A.</creatorcontrib><creatorcontrib>Maguire, D.</creatorcontrib><creatorcontrib>McCormick, P.A.</creatorcontrib><creatorcontrib>Hegarty, J.E.</creatorcontrib><creatorcontrib>Geoghegan, J.G.</creatorcontrib><creatorcontrib>Traynor, O.</creatorcontrib><title>MELD Score as a Prognostic Model for Listing Acute Liver Failure Patients for Liver Transplantation</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>The King’s College Hospital (KCH) criteria are widely used for listing patients with acute liver failure (ALF) for liver transplantation (LT). Recent reports have suggested that the Model for End-Stage Liver Disease (MELD) score may be useful in assessing prognosis in ALF (nonparacetamol). This study compares prognostic accuracy of the two systems in patients with paracetamol (POD)-induced ALF treated in this unit.
Seventy-two patients (average age 38 years; F:M ratio 2:1) admitted from 1994 to 2005 with POD-related ALF were studied. Clinical and biochemical parameters were recorded. The effect of applying a MELD score of greater than 30 as listing criteria for LT was calculated and compared with the KCH criteria. Outcomes were defined as LT, death, or full recovery.
Thirty-one patients (43%) recovered with medical therapy, 29 (40%) patients died, and 12 (17%) underwent LT. Sixty five percent of patients had a MELD > 30 and therefore could potentially be listed on admission; however, using KCH criteria only 24% patients were listed immediately. Sensitivity and negative predictive value of MELD was higher then KCH; however, we found KCH to have much higher specificity and positive predictive value.
MELD has higher sensitivity and negative predictive value for POD-induced ALF than the KCH criteria. However, the high false-positive rate associated with MELD limits its clinical utility. The high negative predictive value of MELD score may allow it to be used in conjunction with KCH criteria to avoid unneeded LT in patients who will likely recover spontaneously.</description><subject>Adult</subject><subject>Bilirubin - blood</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hepatic Encephalopathy - classification</subject><subject>Hepatic Encephalopathy - mortality</subject><subject>Hepatic Encephalopathy - surgery</subject><subject>Humans</subject><subject>International Normalized Ratio</subject><subject>Liver Failure, Acute - classification</subject><subject>Liver Failure, Acute - mortality</subject><subject>Liver Failure, Acute - surgery</subject><subject>Liver Failure, Acute - therapy</subject><subject>Liver Transplantation - statistics & numerical data</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Other diseases. Semiology</subject><subject>Patient Selection</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Survival Analysis</subject><subject>Tissue, organ and graft immunology</subject><subject>Treatment Outcome</subject><subject>Waiting Lists</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkN9LHDEQgEOx1OvpvyChYN_2THaTbNY38UcrnFRQn0NudlZy7G1skhX875vtLdbHwkDIzDeTyUfIN85WnHF1tl2lYIf4EjwgtquSMbWagolPZMF1XRWlKqsDssgZXvBKyEPyNcYty_dSVF_IIVeNZozzBYG76_UVfQAfkNpILb0P_nnwMTmgd77FnnY-0LXLieGZXsCYMN9eMdAb6_oxd93b5HBIcQan0uPf9Xo7pFzzwxH53Nk-4vF8LsnTzfXj5c9i_evH7eXFugBRi1RshISuqltuy04zrTZoOYBu6lrLrlOqQSUkk6LKP6qt5IAN07JmTStls6mwWpLv-7nZzO8RYzI7FwH7vAj6MRqls5vJz5Kc70EIPsaAnXkJbmfDm-HMTIrN1nxUbCbFZgomcvPJ_Mq42eXae-vsNAOnM2Aj2L7Lg8DFf5zmSjDZZO5qz2F28uowmAjZJGDrAkIyrXf_s88fqdGgcA</recordid><startdate>20060901</startdate><enddate>20060901</enddate><creator>Zaman, M.B.</creator><creator>Hoti, E.</creator><creator>Qasim, A.</creator><creator>Maguire, D.</creator><creator>McCormick, P.A.</creator><creator>Hegarty, J.E.</creator><creator>Geoghegan, J.G.</creator><creator>Traynor, O.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20060901</creationdate><title>MELD Score as a Prognostic Model for Listing Acute Liver Failure Patients for Liver Transplantation</title><author>Zaman, M.B. ; Hoti, E. ; Qasim, A. ; Maguire, D. ; McCormick, P.A. ; Hegarty, J.E. ; Geoghegan, J.G. ; Traynor, O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-b45cf37d1a2f8086bea1cc897785ff669e64505431347a51ce9085709d559b3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Bilirubin - blood</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hepatic Encephalopathy - classification</topic><topic>Hepatic Encephalopathy - mortality</topic><topic>Hepatic Encephalopathy - surgery</topic><topic>Humans</topic><topic>International Normalized Ratio</topic><topic>Liver Failure, Acute - classification</topic><topic>Liver Failure, Acute - mortality</topic><topic>Liver Failure, Acute - surgery</topic><topic>Liver Failure, Acute - therapy</topic><topic>Liver Transplantation - statistics & numerical data</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Patient Selection</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Survival Analysis</topic><topic>Tissue, organ and graft immunology</topic><topic>Treatment Outcome</topic><topic>Waiting Lists</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zaman, M.B.</creatorcontrib><creatorcontrib>Hoti, E.</creatorcontrib><creatorcontrib>Qasim, A.</creatorcontrib><creatorcontrib>Maguire, D.</creatorcontrib><creatorcontrib>McCormick, P.A.</creatorcontrib><creatorcontrib>Hegarty, J.E.</creatorcontrib><creatorcontrib>Geoghegan, J.G.</creatorcontrib><creatorcontrib>Traynor, O.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zaman, M.B.</au><au>Hoti, E.</au><au>Qasim, A.</au><au>Maguire, D.</au><au>McCormick, P.A.</au><au>Hegarty, J.E.</au><au>Geoghegan, J.G.</au><au>Traynor, O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MELD Score as a Prognostic Model for Listing Acute Liver Failure Patients for Liver Transplantation</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2006-09-01</date><risdate>2006</risdate><volume>38</volume><issue>7</issue><spage>2097</spage><epage>2098</epage><pages>2097-2098</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><coden>TRPPA8</coden><abstract>The King’s College Hospital (KCH) criteria are widely used for listing patients with acute liver failure (ALF) for liver transplantation (LT). Recent reports have suggested that the Model for End-Stage Liver Disease (MELD) score may be useful in assessing prognosis in ALF (nonparacetamol). This study compares prognostic accuracy of the two systems in patients with paracetamol (POD)-induced ALF treated in this unit.
Seventy-two patients (average age 38 years; F:M ratio 2:1) admitted from 1994 to 2005 with POD-related ALF were studied. Clinical and biochemical parameters were recorded. The effect of applying a MELD score of greater than 30 as listing criteria for LT was calculated and compared with the KCH criteria. Outcomes were defined as LT, death, or full recovery.
Thirty-one patients (43%) recovered with medical therapy, 29 (40%) patients died, and 12 (17%) underwent LT. Sixty five percent of patients had a MELD > 30 and therefore could potentially be listed on admission; however, using KCH criteria only 24% patients were listed immediately. Sensitivity and negative predictive value of MELD was higher then KCH; however, we found KCH to have much higher specificity and positive predictive value.
MELD has higher sensitivity and negative predictive value for POD-induced ALF than the KCH criteria. However, the high false-positive rate associated with MELD limits its clinical utility. The high negative predictive value of MELD score may allow it to be used in conjunction with KCH criteria to avoid unneeded LT in patients who will likely recover spontaneously.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>16980011</pmid><doi>10.1016/j.transproceed.2006.06.004</doi><tpages>2</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0041-1345 |
| ispartof | Transplantation proceedings, 2006-09, Vol.38 (7), p.2097-2098 |
| issn | 0041-1345 1873-2623 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_68873187 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adult Bilirubin - blood Biological and medical sciences Female Fundamental and applied biological sciences. Psychology Fundamental immunology Gastroenterology. Liver. Pancreas. Abdomen Hepatic Encephalopathy - classification Hepatic Encephalopathy - mortality Hepatic Encephalopathy - surgery Humans International Normalized Ratio Liver Failure, Acute - classification Liver Failure, Acute - mortality Liver Failure, Acute - surgery Liver Failure, Acute - therapy Liver Transplantation - statistics & numerical data Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Other diseases. Semiology Patient Selection Prognosis Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Analysis Tissue, organ and graft immunology Treatment Outcome Waiting Lists |
| title | MELD Score as a Prognostic Model for Listing Acute Liver Failure Patients for Liver Transplantation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T16%3A45%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=MELD%20Score%20as%20a%20Prognostic%20Model%20for%20Listing%20Acute%20Liver%20Failure%20Patients%20for%20Liver%20Transplantation&rft.jtitle=Transplantation%20proceedings&rft.au=Zaman,%20M.B.&rft.date=2006-09-01&rft.volume=38&rft.issue=7&rft.spage=2097&rft.epage=2098&rft.pages=2097-2098&rft.issn=0041-1345&rft.eissn=1873-2623&rft.coden=TRPPA8&rft_id=info:doi/10.1016/j.transproceed.2006.06.004&rft_dat=%3Cproquest_cross%3E68873187%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=68873187&rft_id=info:pmid/16980011&rft_els_id=S0041134506006221&rfr_iscdi=true |