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Liver Allocation in Urgent MELD Score ≥30: The Italian Experience.

Abstract：

INTRODUCTION:Patients with an urgent MELD score ≥30 are managed by the Italian Operative National Transplant Center on the basis of a division of Italy into 2 main areas, the northern macro area (NMA) and the southern macro area (SMA). The object of this study was to evaluate the possibility and the need to transform the MELD score ≥30 macro area-based program into a nationwide one. PATIENTS AND METHODS:When a region reports the presence of a patient with a MELD score ≥30, the same macro area-compatible donors, in the absence of urgent national and 1B status, are offered primarily to this recipient. RESULTS:From August 2014 to August 2015, 132 requests for patients with urgent MELD score ≥30, 98 from the NMA and 34 from the SMA, were handled. The average waiting list in the NMA was significantly different from that of the SMA (2.74 ± 2.29 vs 4.5 ± 3.98, P < .05). A total of 73.7% of the received requests (n = 97) were satisfied: the NMA met 80.4% of the requests (n = 77), whereas the SMA met 55.5% (n = 20). A total of 35 requests (26.5%), 21 from the NMA (60%) and 14 (40%) from the SMA, were not met. The average waiting time of these recipients for a liver was significantly different between the NMA and the SMA (3.14 ± 3.21 vs 5.78 ± 4.59; P < .05). CONCLUSIONS:The MELD score is a priority allocation, and the longer the waiting time to transplantation for these recipients, the more their mortality increases. Given the differences in waiting times between the NMA and SMA, we should start thinking about transforming the macro area program into a national one.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Trapani S,Morabito V,Oliveti A,Peritore D,Rizzo A,Cacciotti AR,Gaeta A,Montemurro A,Rizzato L,Nanni Costa A

doi

10.1016/j.transproceed.2015.12.047

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

299-303

issue

2

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(16)00068-3

journal_volume

48

pub_type

杂志文章

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