ArticleTransplantation2020
Patients With Persistently Low MELD-Na Scores Continue to Be at Risk of Liver-related Death.
Article in Transplantation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Systematic review and meta-analysis of biomarkers predicting decompensation in patients with compensated cirrhosis.BMJ open gastroenterology · 2024Pooled it
- Review article: Immunosuppression in Decompensated Autoimmune Hepatitis Cirrhosis - To Suppress or Not to Suppress?Alimentary pharmacology & therapeutics · 2026Review
- Update on Organ Allocation and Liver Transplantation.Gastroenterology & hepatology · 2025Article
- Article
- Comparing Functional Frailty and Radiographic Sarcopenia as Predictors of Outcomes After Liver Transplant.Clinical transplantation · 2024Article
- 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
- sTREM-1 as promising prognostic biomarker for acute-on-chronic liver failure and mortality in patients with acute decompensation of cirrhosis.World journal of gastroenterology · 2024Article
- MELD-Na score may underestimate disease severity and risk of death in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).Scientific reports · 2023Article
- Establishing a HOPE Program in a Real-life Setting: A Brazilian Case Series.Transplantation direct · 2023Article
- Clinical Course and Outcomes of Patients with Nonalcoholic Fatty Liver Disease-Related Hepatocellular Cancer (NAFLD-HCC).Digestive diseases and sciences · 2023Article
- Management of refractory ascites.Clinical and molecular hepatology · 2023Review
- Accurate long-term prediction of death for patients with cirrhosis.Hepatology (Baltimore, Md.) · 2022Article
- Sex Disparities in Outcome of Patients with Alcohol-Related Liver Cirrhosis within the Eurotransplant Network-A Competing Risk Analysis.Journal of clinical medicine · 2022Article
- Corrigendum to 'Level of MFAP4 in ascites independently predicts 1-year transplant-free survival in patients with cirrhosis' [JHEP Reports 3 (2021) 100287].JHEP reports : innovation in hepatology · 2021Article
- Level of MFAP4 in ascites independently predicts 1-year transplant-free survival in patients with cirrhosis.JHEP reports : innovation in hepatology · 2021Article
- 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
- Incorporation of frailty estimated by gait speed within MELD-Na and the predictive potential for mortality in cirrhosis.Therapeutic advances in chronic disease · 2020Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe vast majority of patients with cirrhosis have low Model for End-Stage Liver Disease-Sodium (MELD-Na) scores; however, the ability for the MELD-Na score to predict patient outcomes at low scores is unclear.
methodsAdult patients in a multicenter, Chicago-wide database of medical records with International Classification of Disease, Ninth Edition codes of cirrhosis and without a history of hepatocellular carcinoma were included. Records were linked with the state death registry, and death certificates were manually reviewed. Deaths were classified as "liver-related," "non-liver-related," and "non-descript" as adjudicated by a panel comprised of a transplant surgeon, a hepatologist, and an internist. A sensitivity analysis was performed where patients with hepatocellular carcinoma were included.
resultsAmong 7922 identified patients, 3999 patients had MELD-Na scores that were never higher than 15. In total, 2137 (27%) patients died during the study period with higher mortality rates for the patients in the high MELD-Na group (19.4 (41.6%) versus 4.1 (12.6%) per 100 person-y, P < 0.001). The high MELD-Na group died of a liver-related cause in 1142 out of 1632 (70%) as compared to 240 out of 505 (47.5%) deaths in the low MELD-Na group. There was no difference in the distribution of subcategory of liver-related death between low and high MELD-Na groups. Among subclassification of liver-related deaths, the most common cause of death was "Infectious" in both groups.
conclusionsDespite persistently low MELD-Na scores, patients with cirrhosis still experience high rates of liver-related mortality.
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