Improved waiting-list outcomes in Argentina after the adoption of a model for end-stage liver disease-based liver allocation policy.

摘要: In July 2005, Argentina became the first country after United States to introduce Model for End-Stage Liver Disease (MELD) organ allocation. this study, we investigated waiting-list (WL) outcomes (n = 3272) and post-liver transplantation (LT) survival in 2 consecutive periods of 5 years before implementation a MELD-based allocation policy. Data were obtained from database national institute Argentina. After adoption MELD system, there significant reductions WL mortality [28.5% versus 21.9%, P   30 had lower posttransplant survival, global accuracy score predicting was poor, as indicated by c statistic only 0.523. Patients with granted exceptions (158 hepatocellular carcinoma 52 other reasons) significantly higher access LT (80.4%) comparison nonexception patients equivalent listing priority (MELD score = 18-25; 54.6%, P < 0.001, HR = 0.49, 95% CI = 0.40-0.61). conclusion, model has resulted improved liver without compromising survival.