dc.contributor.author
Ritschl, Paul V.
dc.contributor.author
Wiering, Leke
dc.contributor.author
Dziodzio, Tomasz
dc.contributor.author
Jara, Maximilian
dc.contributor.author
Kruppa, Jochen
dc.contributor.author
Schoeneberg, Uwe
dc.contributor.author
Raschzok, Nathanael
dc.contributor.author
Butz, Frederike
dc.contributor.author
Globke, Brigitta
dc.contributor.author
Seika, Philippa
dc.contributor.author
Maurer, Max
dc.contributor.author
Biebl, Matthias
dc.contributor.author
Schöning, Wenzel
dc.contributor.author
Schmelzle, Moritz
dc.contributor.author
Sauer, Igor M.
dc.contributor.author
Tacke, Frank
dc.contributor.author
Öllinger, Robert
dc.contributor.author
Pratschke, Johann
dc.date.accessioned
2020-10-16T11:32:27Z
dc.date.available
2020-10-16T11:32:27Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/28490
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-28239
dc.description.abstract
The Model for End-Stage Liver Disease (MELD)-based allocation system was implemented in Germany in 2006 in order to reduce waiting list mortality. The purpose of this study was to evaluate post-transplant results and waiting list mortality since the introduction of MELD-based allocation in our center and in Germany. Adult liver transplantation at the Charité-Universitätsmedizin Berlin was assessed retrospectively between 2005 and 2012. In addition, open access data from Eurotransplant (ET) and the German Organ Transplantation Foundation (DSO) were evaluated. In our department, 861 liver transplantations were performed from 2005 to 2012. The mean MELD score calculated with the laboratory values last transmitted to ET before organ offer (labMELD) at time of transplantation increased to 20.1 from 15.8 (Pearson's R = 0.121, p < 0.001, confidence interval (CI) = 0.053-0.187). Simultaneously, the number of transplantations per year decreased from 139 in 2005 to 68 in 2012. In order to overcome this organ shortage the relative number of utilized liver donors in Germany has increased (85% versus 75% in non-German ET countries). Concomitantly, 5-year patient survival decreased from 79.9% in 2005 to 60.3% in 2012 (p = 0.048). At the same time, the ratio of waiting list mortality vs. active-listed patients nearly doubled in Germany (Spearman's rho = 0.903, p < 0.001, CI = 0.634-0.977). In low-donation areas, MELD-based liver allocation may require reconsideration and inclusion of prognostic outcome factors
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
liver transplantation
en
dc.subject
allocation policy
en
dc.subject
donor shortage
en
dc.subject
organ donation
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
The Effects of MELD-Based Liver Allocation on Patient Survival and Waiting List Mortality in a Country with a Low Donation Rate
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
1929
dcterms.bibliographicCitation.doi
10.3390/jcm9061929
dcterms.bibliographicCitation.journaltitle
Journal of Clinical Medicine
dcterms.bibliographicCitation.originalpublishername
MDPI AG
dcterms.bibliographicCitation.volume
9
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.isSupplementedBy.url
http://www.mdpi.com/2077-0383/9/6/1929/s1
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
32575598
dcterms.isPartOf.eissn
2077-0383