ArticleAnnals of gastroenterology
Validation of gender-equity model for liver allocation (GEMA) and its sodium variant (GEMA-Na) in candidates for liver transplantation.
Article in Annals of gastroenterology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Beyond Rebalanced Haemostasis: Haemostatic Phenotypes, Thrombin Generation, and Clinical Risk in Chronic Liver Disease.TH open : companion journal to thrombosis and haemostasis · 2026Review
- Improved Discrimination and Predictive Ability of Novel Prognostic Scores for Long-term Mortality in Hospitalized Patients with Cirrhosis.Journal of clinical and translational hepatology · 2025Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The current allocation system for liver transplantation (LT) is based on the sickest-first policy, using objective variables to ensure equal priority. However, under-prioritization of female patients for LT, compared to males, is well demonstrated and new scores have been proposed to overcome this systematic bias. This study evaluated the ability of these new scores to predict the long-term outcomes of patients with cirrhosis. Methods: The clinical and laboratory characteristics of 694 consecutive candidates for liver transplantation from 2 liver transplant centers were recorded. The model for end-stage liver disease (MELD)-based scores (MELD, MELD-Sodium and MELD 3.0), as well as the Gender-Equity Model for liver Allocation (GEMA) and GEMA-Sodium, were used to assess the severity of liver disease. Patients were followed-up prospectively and their outcomes assessed. Results: During a follow-up period of median length 12 months (range: 4-52), 28.5% of patients died, 21% of patients underwent LT, while 50.5% remained alive. Female patients had significantly lower MELD and MELD-Sodium scores compared to males, attributable to their significantly lower creatinine, while MELD 3.0, GEMA and GEMA-Sodium did not differ between the 2 sexes. In multivariate Cox regression analysis, GEMA-Sodium was the only factor independently associated with death/LT, and showed very good discriminative ability (hazard ratio 1.10, 95% confidence interval 1.073-1.128; P<0.001). These findings were confirmed in several subgroup analyses. Conclusions: Our findings show for the first time the predictive ability of GEMA-Sodium for the long-term outcomes of LT candidates. However, further studies are needed to confirm these findings.
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