Evidence map›Paper›PMID 40810862›Full record

ArticleJournal of gastroenterology2025

Current status of waitlist mortality and transplant probability for adult candidates with chronic end-stage liver disease for deceased donor liver transplantation under the Model for End-Stage Liver Disease score-based allocation policy in Japan.

Yusuke Takemura, Yoshihide Ueda, Ryo Takemura, Junya Mita, Juntaro Ashikari, Kaori Kuramitsu, Yasushi Hasegawa, Minoru Kitago, Hideaki Obara, Yuko Kitagawa and 2 more

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Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yusuke TakemuraDivision of Investigation and Research, Japan Organ Transplant Network, 3-26-1 Kaigan, Minato-ku, Tokyo, 108-0022, Japan. yusuketkmr@gmail.com.ORCID 0000-0003-3791-9902
Yoshihide UedaDepartment of Gastroenterology, Kakogawa Central City Hospital, 439 Honmachi, Kakogawa-cho, Kakogawa, Hyogo, 675-0037, Japan.
Ryo TakemuraBiostatistics Unit, Clinical and Translational Research Center, Keio University School of Medicine, Tokyo, 160-8582, Japan.
Junya MitaDivision of Investigation and Research, Japan Organ Transplant Network, 3-26-1 Kaigan, Minato-ku, Tokyo, 108-0022, Japan.
Juntaro AshikariDivision of Investigation and Research, Japan Organ Transplant Network, 3-26-1 Kaigan, Minato-ku, Tokyo, 108-0022, Japan.
Kaori KuramitsuJapan Organ Transplant Network, 3-26-1 Kaigan, Minato-ku, Tokyo, 108-0022, Japan.
Yasushi HasegawaDepartment of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Minoru KitagoDepartment of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Hideaki ObaraDepartment of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Yuko KitagawaDepartment of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Hideki OhdanDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan.
Hiroyuki YokotaJapan Organ Transplant Network, 3-26-1 Kaigan, Minato-ku, Tokyo, 108-0022, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Japan's deceased-donor liver transplantation (DDLT), a new allocation policy based on the Model for End-Stage Liver Disease (MELD) score, including the exceptional MELD system (Ex-MELD), which periodically assigns additional points to the basal MELD score, was implemented in May 2019. We assessed the current state of this system for adult candidates with chronic end-stage liver disease.

methodsAdult candidates (≥ 18 years) registered in the Japan Organ Transplant Network for DDLT as Status 2 cases (including chronic end-stage liver disease patients) between May 2019 and April 2023 were evaluated. We divided them into the MELD, Ex-MELD (major) [start 16 points, 2 points by 180 days], and Ex-MELD [hepatocellular carcinoma (HCC)] groups. Transplant probability and waitlist mortality rates were compared using competing risk analyses. The annual proportion of DDLT and the transition of median MELD at transplantation were also investigated.

resultsThere were 757 candidates in MELD,126 in Ex-MELD (major), and 99 in Ex-MELD (HCC) groups. The transplant probability rates were not significantly different (3-year transplant probability rate; MELD: 24.0% vs. Ex-MELD (major): 21.0% vs. Ex-MELD (HCC): 24.1%). The rate in the Ex-MELD (major) increased dramatically as the waiting period lengthened. The waitlist mortality rates in the Ex-MELD (major) group were significantly lower (3-year waitlist mortality rate; MELD: 50.5% vs. Ex-MELD (major): 25.0% vs. Ex-MELD (HCC): 57.0%). Although the proportion of Ex-MELD (major) increased yearly in the transplanted cases, the median MELD at transplantation did not change significantly.

conclusionsWe clearly showed the current status of adult Status 2 candidates.

Indexed as

End Stage Liver DiseaseLiver TransplantationTissue and Organ ProcurementWaiting ListsAdultAgedCarcinoma, HepatocellularFemaleHumansJapanLiver NeoplasmsMaleMiddle AgedProbabilityResource AllocationSeverity of Illness IndexDeceased donor liver transplantationModel for End-Stage Liver Disease scoreTransplant probabilityWaitlist mortality

Identifiers

PMID40810862

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.