Thanks to a new scoring system, patients with the greatest
need will be the ones to most benefit from liver transplants, according to a
study published in the November 26 issue of the Journal of the American Medical
Association.
A new medical approach called MELD (Model for End-Stage
Liver Disease) is helping black patients who are more likely to have to wait
longer on the U.S.’s
liver transplant list. A new study found an elimination in racial disparity
since the system has been implemented, in 2002. Risk of death or becoming very
ill within 3 years of waiting on the organ transplant list was higher in black
patients before 2002, compared to white patients (27.0 percent vs. 21.7 percent),
but not after MELD was adopted (26.5 percent vs. 22.0 percent). Now "the
sickest patients get" the organs, said Cynthia A. Moylan, M.D., of Duke University
Medical Center,
Durham, N.C.
But it seems that women aren’t that lucky, since they are still at the bottom
of liver transplant waiting lists. Researchers can’t justify why sex
differences persist regardless of using the new system. "One possibility
is that the creatinine, which is the measure of their kidney function and is a
key part of the MELD score, is in general lower for women,” said Dr. Andrew
Muir, a hematologist at Duke University.
At present, the number of Americans waiting for a new liver
tops 16,000, the United Network for Organ Sharing says. One year following the
transplant, overall survival rates go beyond 90%.
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