Purpose The new allocation policy based on model for end-stage liver disease (MELD) score predicts severity of chronic liver disease. The MELD score is derived from the levels of bilirubin, INR and creatinine but does not account for other manifestations of severe liver disease. Hepatitis C is the most common indication for liver transplant in the US. Our aim was to assess the performance of MELD score in patients with viral hepatitis awaiting transplantation.
Methods Data from the Organ Procurement database for liver transplant (LT) candidates were collected from February, 2002 through 2004, representing the first 23 month's experience with the new plan. Patients with HCV ±HBV±HAV induced PNC were compared to non-HCV ±HBV±HAV PNC for the time on waiting list, numbers of transplants, removals from the waiting list because of death or “too sick”, MELD score values, creatinine, INR and bilirubin. Status 1 and hepatoma patients were excluded. (Table)
Conclusions Patients with viral hepatitis have lower levels of bilirubin, INR and creatinine which leads to lower MELD at listing, longer waiting times for transplant and lower rates of LT without an increase in the rate of removal from transplant due to death or “too sick”.