Results after the adoption of a MELD/PELD‐based liver allocation policy in Argentina |
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| Authors: | Marcelo Dip Nora Cejas Guillermo Cervio Federico Villamil Viviana Tagliafichi Daniela Hansen Krogh Oscar Imventarza Carlos Soratti Liliana Bisigniano |
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| Institution: | 1. Sociedad Argentina de Trasplante, Ciudad Autonoma de Buenos Aires, Argentina;2. Instituto Nacional Central Unico Coordinador de Ablación e Implante (INCUCAI), Ciudad Autonoma de Buenos Aires, Argentina;3. Hospital de Pediatría Prof. Dr. JP Garrahan, Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina;4. Hospital Dr. Cosme Argerich, Ciudad Autonoma de Buenos Aires, Argentina;5. Hospital Británico, Ciudad Autonoma de Buenos Aires, Argentina |
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| Abstract: | In July 2005, Argentina switched from a categorical liver allocation system to a MELD/PELD‐based policy for patients with CLD. To analyze WL outcomes and survival after LT in children. From January 2000 to December 2010, 923 children were registered. Two consecutive five‐yr periods were analyzed and compared: Era I (January 2000–July 2005) (n = 379) and Era II (July 2005–December 31, 2010) (n = 544). All data were prospectively collected and analyzed using the Kaplan–Meier method. After adopting the MELD/PELD system, WL registrations increased by 44% (from 379 to 544) and the number of LT increased by only 24% (from 278 to 365). However, three‐month WL mortality rate (32% to 18%, p < 0.0001, HR 2.002 CI 95% 1.5–2.8) decreased significantly. No significant differences were observed between Era 1 and II in one‐yr post‐LT survival (77.5% vs. 84.1%, p = 0.3053) and in acute re‐LT rate (9% vs. 5%, p = 0.1746). Under the MELD/PELD‐based allocation system in Argentina, mortality on the WL significantly decreased in children with CLD without affecting post‐LT survival, although reduced access to LT was observed. |
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| Keywords: | pediatric liver transplant waiting list outcomes waiting list mortality pediatric end‐stage liver disease impact survival |
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