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High-resolution Melting PCR for Complement Receptor 1 Length Polymorphism Genotyping: An Innovative Tool for Alzheimer's Disease Gene Susceptibility Assessment
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Region 11 MELD Na exception prospective study.

Robert A Fisher1, Douglas M Heuman, Ann M Harper

  • 1Department of Surgery/Medicine, Virginia Commonwealth University, Medical College of Virginia Hospitals, Hume/Lee Transplant Ctr., Richmond Virginia, USA. rafisher@vcu.edu

Annals of Hepatology
|December 15, 2011
PubMed
Summary
This summary is machine-generated.

Hyponatremia in cirrhosis patients complicates liver transplants. A MELD Na exception improved access to transplantation for these patients without impacting transplant success rates.

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Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Nephrology

Background:

  • Hyponatremia is a common complication in cirrhosis patients.
  • It is associated with increased short-term mortality and adverse outcomes.
  • These outcomes extend to the pre- and post-liver transplantation periods.

Purpose of the Study:

  • To evaluate the impact of a sodium (Na) exception policy on liver transplant access for cirrhotic patients with hyponatremia.
  • To determine if this exception policy affects transplant efficacy.

Main Methods:

  • Adult candidates for primary liver transplantation with cirrhosis and hyponatremia in Region 11 were eligible for a Na exception.
  • Patients with serum sodium (SNa) < 130 mg/dL, measured twice within 30 days, qualified for pre-approved Na exception.
  • Model for End Stage Liver Disease (MELD) Na score was calculated and capped at 22.

Main Results:

  • Ninety percent of MELD Na exception patients were transplanted, compared to 49% of standard MELD patients in Region 11.
  • Transplant and dropout rates were comparable between MELD Na, HCC MELD, and standard MELD groups.
  • Six-month post-transplant survival rates were similar across all groups (92.2%–93.9%).

Conclusions:

  • The MELD Na exception policy in Region 11 improved equitable access to liver transplantation for hyponatremic cirrhotic patients.
  • The policy did not compromise the efficacy of liver transplantation.