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Awarding additional MELD points to the shortest waitlist candidates improves sex disparity in access to liver transplant in the United States.
Bernards, Sarah; Lee, Eric; Leung, Ngai; Akan, Mustafa; Gan, Kyra; Zhao, Huan; Sarkar, Monika; Tayur, Sridhar; Mehta, Neil.
Afiliação
  • Bernards S; University of California, San Francisco, San Francisco, California, USA.
  • Lee E; University of California, San Francisco, San Francisco, California, USA.
  • Leung N; City University of Hong Kong, Kowloon, Hong Kong.
  • Akan M; Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
  • Gan K; Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
  • Zhao H; City University of Hong Kong, Kowloon, Hong Kong.
  • Sarkar M; University of California, San Francisco, San Francisco, California, USA.
  • Tayur S; Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
  • Mehta N; University of California, San Francisco, San Francisco, California, USA.
Am J Transplant ; 22(12): 2912-2920, 2022 12.
Article em En | MEDLINE | ID: mdl-35871752
ABSTRACT
Since the introduction of the MELD-based allocation system, women are now 30% less likely than men to undergo liver transplant (LT) and have 20% higher waitlist mortality. These disparities are in large part due to height differences in men and women though no national policies have been implemented to reduce sex disparities. Patients were identified using the Scientific Registry of Transplant Recipients (SRTR) from 2014 to 2019. Patients were categorized into five groups by first dividing into thirds by height then dividing the shortest third into three groups to capture more granular differences in the most disadvantaged patients (<166 cm). We then used LSAM to model waitlist outcomes in five versions of awarding additional MELD points to shorter candidates compared to current policy. We identified two proposed policy changes LSAM scenarios that resulted in improvement in LT and death percentage for the shortest candidates with the least negative impact on taller candidates. In conclusion, awarding an additional 1-2 MELD points to the shortest 8% of LT candidates would improve waitlist outcomes for women. This strategy should be considered in national policy allocation to address sex-based disparities in LT.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Obtenção de Tecidos e Órgãos / Transplante de Fígado / Doença Hepática Terminal Limite: Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: Am J Transplant Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Obtenção de Tecidos e Órgãos / Transplante de Fígado / Doença Hepática Terminal Limite: Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: Am J Transplant Ano de publicação: 2022 Tipo de documento: Article