ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2017
Mortality Risk Factors Among Patients With Cirrhosis and a Low Model for End-Stage Liver Disease Sodium Score (≤15): An Analysis of Liver Transplant Allocation Policy Using Aggregated Electronic Health Record Data.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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26 citing papers in PubMed, 57 citations in OpenAlex.
- Predictors of spontaneous bacterial peritonitis among cirrhotic patients with ascites in Dodoma, Tanzania: a cross-sectional study.Future science OA · 2026Article
- The survival benefit of deceased donor liver transplantation using MELD 3.0: A contemporary analysis.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- Frailty Increases Hospitalization Rates in an Ambulatory Cohort of Patients With Cirrhosis: The North American Consortium for the Study of End-Stage Liver Disease 3 Prospective Cohort.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Large Language Models can Identify the Presence of MASH and Extract VCTE Measurements from Unstructured Documentation.Digestive diseases and sciences · 2026Article
- Demand, Waitlisting and Transplantation Around the World: The Axiomatic View of Scarcity in Liver Transplantation.Clinical transplantation · 2026Article
- Artificial intelligence in liver transplantation: Opportunities and challenges.World journal of gastrointestinal surgery · 2025Review
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- Where you live matters: Area deprivation predicts poor survival and liver transplant waitlisting.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
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- MELD 3.0 adequately predicts mortality and renal replacement therapy requirements in patients with alcohol-associated hepatitis.JHEP reports : innovation in hepatology · 2023Article
- Accurate long-term prediction of death for patients with cirrhosis.Hepatology (Baltimore, Md.) · 2022Article
- "Beyond MELD" - Emerging strategies and technologies for improving mortality prediction, organ allocation and outcomes in liver transplantation.Journal of hepatology · 2022Review
- Living donor liver transplantation versus donation after brain death and donation after circulatory death liver transplantation in the US.Proceedings (Baylor University. Medical Center) · 2022Article
- The Addition of C-Reactive Protein and von Willebrand Factor to Model for End-Stage Liver Disease-Sodium Improves Prediction of Waitlist Mortality.Hepatology (Baltimore, Md.) · 2021Article
- Malnutrition in Patients with Liver Cirrhosis.Nutrients · 2021Review
- Electronic Medical Record-Based Case Phenotyping for the Charlson Conditions: Scoping Review.JMIR medical informatics · 2021Article
- The Patient-Centered Outcomes Research Network Antibiotics and Childhood Growth Study: Implementing Patient Data Linkage.Population health management · 2020Article
- Liver-related mortality is similar among men and women with cirrhosis.Journal of hepatology · 2020Article
- Pre and post-liver transplant outcome of cirrhotic patients with acute on chronic liver failure.Medicine · 2020Observational
- Application of Hepatic Venous Pressure Gradient to Predict Prognosis in Cirrhotic Patients with a Low Model for End-Stage Liver Disease Score.Diagnostics (Basel, Switzerland) · 2020Article
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14 authors at 2 institutions in 2 countries.
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Abstract
Although the Model for End-Stage Liver Disease sodium (MELD Na) score is now used for liver transplant allocation in the United States, mortality prediction may be underestimated by the score. Using aggregated electronic health record data from 7834 adult patients with cirrhosis, we determined whether the cause of cirrhosis or cirrhosis complications was associated with an increased risk of death among patients with a MELD Na score ≤15 and whether patients with the greatest risk of death could benefit from liver transplantation (LT). Over median follow-up of 2.3 years, 3715 patients had a maximum MELD Na score ≤15. Overall, 3.4% were waitlisted for LT. Severe hypoalbuminemia, hepatorenal syndrome, and hepatic hydrothorax conferred the greatest risk of death independent of MELD Na score with 1-year predicted mortality >14%. Approximately 10% possessed these risk factors. Of these high-risk patients, only 4% were waitlisted for LT, despite no difference in nonliver comorbidities between waitlisted patients and those not listed. In addition, risk factors for death among waitlisted patients were the same as those for patients not waitlisted, although the effect of malnutrition was significantly greater for waitlisted patients (hazard ratio 8.65 [95% CI 2.57-29.11] vs. 1.47 [95% CI 1.08-1.98]). Using the MELD Na score for allocation may continue to limit access to LT.
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