New Organ Allocation Model Decreases Deaths on Liver Transplant Waiting List

(Ivanhoe Newswire) – Changing how donated livers are allocated to potential transplant patients seems to decrease the number of deaths among those on the waiting list and shorten the time to transplantation. That’s according to new research from Vanderbilt University Medical Center.

In 2002, the Model for End-stage Liver Disease (MELD) score was adopted to try to allocate donor organs in a fairer way based on medical urgency. Researchers looked at the outcomes associated with this change in policy by studying patients on the waiting list 36 months before and 29 months after the MELD scoring system was adopted.

The study found an immediate increase in the number of deaths after the change of policy – from about 11 to 13 per 1,000 patients on the waiting list per month. But over time this declined by about .09 deaths per 1,000 registrants per month. And the waiting time for a liver decreased from about 294 to 250 days.

“With the transition in allocation policy from a system that emphasized waiting time to one that favored disease severity with a de-emphasis on patient waiting time, many less-ill registrants placed on the list for the sole purpose of ‘banking time’ may have been removed, leading to an overall decrease in the time to transplantation for the remaining registrants,” write the authors.

The report also shows the policy change did not seem to affect the number of new registrants per month or the survival rates three or six months after a transplant.

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SOURCE: Archives of Surgery, 2007;142:1079-1085

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