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Langenbeck's Archives of Surgery

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01-04-2011 | Review Article

Liver transplantation in the high MELD era: a fair chance for everyone?

Authors: Marcus Bahra, Peter Neuhaus

Published in: Langenbeck's Archives of Surgery | Issue 4/2011

Abstract

Introduction

In 2006, the model for end-stage liver disease (MELD) was introduced in Germany. Recent data clearly show a decrease of mortality on the waiting list but also a decrease of post-liver transplant survival. Several factors are discussed to be responsible for that; although, a MELD >30 is known to be major risk factor for outcome, MELD scores have increased to over 30 since introduction of the MELD system. On the other hand, the quality of donor organs is deteriorating from year to year at the same time.

Results

To date, we have to face the dilemma of organ allocation to significantly sicker patients resulting in a noticeably worsening of post-orthotopic liver transplant (OLT) results. The question is how to keep an acceptable standard of post-OLT results.

Conclusion

Should allocation guidelines be modified? A further significant question is: How fair is the current allocation system for patients on the waiting list? Does the MELD score privileges or discriminates potential organ recipients?

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Title: Liver transplantation in the high MELD era: a fair chance for everyone?
Authors: Marcus Bahra
Peter Neuhaus
Publication date: 01-04-2011
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 4/2011
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-011-0766-y

At a glance: The STEP trials

Springer Medicine

Liver transplantation in the high MELD era: a fair chance for everyone?

Abstract

Introduction

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Results

Conclusion

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