Waiting list outcome of Peld/Meld exceptions: A single‐center experience in Argentina. (3rd January 2018)

• Record Type: Journal Article
• Authors: Lauferman, Leandro; Dip, Marcelo; Halac, Esteban; Cervio, Guillermo; Aredes, Diego; Capparelli, Mauro; Reijenstein, Hayellen; Minetto, Julia; Rojas, Luis; Goñi, Javier; Jacobo Dillon, Agustina; Martinitto, Roxana; Imventarza, Oscar
• Is Part Of: Pediatric transplantation. Volume 22:Number 2(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-01-03
• Subjects: exception scores -- liver transplantation -- pediatric liver allocation; Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.13107
• Languages: English
• ISSNs: 1397-3142

Abstract

Abstract: As PELD/MELD‐based allocation policy was adopted in Argentina in 2005, a system of exception points has been in place in order to award increased waitlist priority to those patients whose severity of illness is not captured by the PELD/MELD score. We aimed to investigate the WL outcome of patients with granted PELD/MELD exceptions. A retrospective cohort study was conducted in children under 18 years old. WL outcomes were evaluated using univariable analysis. From 07/2005 to 01/2014, 408 children were listed for LT. There were 304 classified by calculated PELD/MELD. During this time, 85 (30%) PELD/MELD exceptions were granted. In this cohort, 89.4% (76 of 85) were transplanted and 7.1% (6 of 85) died while on the WL. The remaining 3 pts (3.5%) were removed from the WL due to other causes. We compared the impact of PELD/MELD exceptions in those 85 patients to outcomes in 87 non‐exception patients with PELD/MELD ≥19 points. Patients with the exception had significantly better access to WL and lower WL mortality. Our data suggest that children listed by PELD/MELD exceptions had an advantage compared to children with CLD with equivalent PELD/MELD listing priorities.