Elective liver transplant list mortality: development of a United Kingdom end-stage liver disease score

Kerri Barber, Susanna Madden, Joanne Allen, Dave Collett, James Neuberger, Alexander Gimson, United Kingdom Liver Transplant Selection and Allocation Working Party, David Mutimer

Research output: Contribution to journalArticlepeer-review

93 Citations (Scopus)

Abstract

BACKGROUND: Prediction of short-term survival probability is important in the selection and allocation of patients for liver transplantation, and the Mayo End-Stage Liver Disease (MELD) score has been used in these contexts. The aim of this study was to develop and validate a model for estimation of short-term prognosis of patients selected for elective liver transplantation in the United Kingdom.

METHODS: A modeling dataset was based on 1103 adult patients registered for a first elective liver transplant in the United Kingdom between April 1, 2003, and March 31, 2006, and a validation dataset based on 452 patients registered between April 1, 2006, and March 31, 2007. The final model (United Kingdom End-Stage Liver Disease) included international normalized ratio, serum creatinine, bilirubin, and sodium.

RESULTS: The model, based on the modeling dataset, accurately predicted mortality on the transplant list in the validation dataset and proved to be a better predictor than MELD or MELD-Na. The United Kingdom End-Stage Liver Disease score was not associated with overall posttransplant survival but was associated with both the duration of intensive care unit stay and overall initial hospital stay.

CONCLUSION: This model, developed specifically for patients awaiting liver transplantation, provides a useful tool for the selection of patients for liver transplantation and the allocation of donor livers.

Original languageEnglish
Pages (from-to)469-76
Number of pages8
JournalTransplantation
Volume92
Issue number4
DOIs
Publication statusPublished - 27 Aug 2011

Keywords

  • Adolescent
  • Adult
  • Aged
  • Bilirubin
  • Creatinine
  • Databases, Factual
  • End Stage Liver Disease
  • Female
  • Great Britain
  • Humans
  • International Normalized Ratio
  • Liver Transplantation
  • Male
  • Middle Aged
  • Models, Biological
  • Models, Statistical
  • Patient Selection
  • Risk Factors
  • Sodium
  • Survival Analysis
  • Waiting Lists
  • Young Adult

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