Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 1 de 1
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Transplant Proc ; 45(6): 2111-4, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23747144

RESUMO

BACKGROUND: In July 2006, the system for liver allocation in Brazil started to rely on the Model for End-stage Liver Disease (MELD) scale, replacing the previous chronological criteria. Under the new system, the score for listing pediatric patients is obtained by multiplication of the calculated PELD score by 3. The current criteria also features extra points for diseases such as hepatocellular carcinoma (HCC). This study sought to analyze the consequences of implementation of the MELD system on waiting list mortality, posttransplant survival rates and characteristics of the transplanted patients. METHODS: We retrospectively studied data from the State Health Secretariat of São Paulo, regarding all patients registered on the waiting list for liver transplantation in the State of São Paulo, in two periods: July 2005 to July 2006 (pre-MELD era) and July 2006 to July 2010 (MELD era). Patient survival rates calculated using the Kaplan-Meier method were compared by the log-rank test. P values <.05 were considered statistically relevant. RESULTS: After implementation of the MELD, waiting list registrations decreased by 39.8%; the percentage of transplants in HCC recipients increased from 2.4% to 23.7%; pediatric transplants increased from 6.5% to 9.3%; deaths on the list fell from 599 in the pre-MELD era to 359 in the last year analyzed; recipients with higher MELD displayed significantly lower posttransplant survival rates; HCC patients, better survival after transplantation (P = .002); No difference was observed comparing survival rates between pre-MELD and MELD eras (P = 474) or between adults and children (P = .867). CONCLUSION: Under the MELD system for liver allocation in Brazil, there was a reduction in waiting list mortality and an increased number of transplantations in pediatric and HCC recipients. Survival rates of patients with higher MELD score were inferior. However, this result was offset by the greater survival in HCC recipients, with no difference in patient survival rates between the pre-MELD and MELD eras.


Assuntos
Técnicas de Apoio para a Decisão , Hepatopatias/diagnóstico , Hepatopatias/cirurgia , Transplante de Fígado , Seleção de Pacientes , Obtenção de Tecidos e Órgãos , Fatores Etários , Brasil , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/cirurgia , Humanos , Estimativa de Kaplan-Meier , Hepatopatias/mortalidade , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/cirurgia , Transplante de Fígado/efeitos adversos , Transplante de Fígado/mortalidade , Valor Preditivo dos Testes , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Listas de Espera/mortalidade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...