The von Willebrand Factor Facilitates Model for End‐Stage Liver Disease–Independent Risk Stratification on the Waiting List for Liver Transplantation

摘要: BACKGROUND AND AIMS The Model for End-Stage Liver Disease (MELD) is used clinical decision-making and organ allocation orthotopic liver transplantation (OLT) was previously upgraded through inclusion of serum sodium (Na) concentrations (MELD-Na). However, MELD-Na may underestimate complications arising from portal hypertension or infection. von Willebrand factor (vWF) antigen (vWF-Ag) correlates with pressure seems capable predicting in patients cirrhosis. Accordingly, this study aimed to evaluate vWF-Ag as an adjunct surrogate marker risk stratification on the waiting list OLT. APPROACH RESULTS Hence, WF-Ag at time listing assessed listed Clinical characteristics, MELD-Na, mortality were recorded. Prediction 3-month waiting-list survival by receiver operating characteristics net reclassification improvement. Interestingly, dying within 3 months displayed elevated levels (P < 0.001). comparable independent their predictive potential (area under curve [AUC], vWF-Ag = 0.739; MELD-Na = 0.764). Importantly, a cutoff 413% identified death higher odds ratio (OR) than published 20 points (vWF-Ag, OR = 10.873, 95% confidence interval [CI], 3.160, 36.084; OR = 7.594, CI, 2.578, 22.372; P < 0.001, respectively). Ultimately, into equation significantly improved prediction (AUC, MELD-Na-vWF = 0.804). CONCLUSIONS A single measurement OLT predicts early mortality. Combining improves help prioritize decrease