Gastroenterology
Volume 135, Issue 5 , Pages 1568-1574 , November 2008

Impact of the Model for End-Stage Liver Disease Allocation Policy on the Use of High-Risk Organs for Liver Transplantation

  • Michael L. Volk

      Affiliations

    • Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan
    • VA Health Services Research and Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
    • Corresponding Author InformationAddress reprint requests to: Michael L. Volk, MD, MSc, Division of Gastroenterology and Hepatology, University of Michigan, 300 N Ingalls 7C27, Ann Arbor, Michigan 48109. fax: (734) 936-8944
    • ,
  • Anna S.F. Lok

      Affiliations

    • Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan
    • ,
  • Shawn J. Pelletier

      Affiliations

    • Division of Transplant Surgery, University of Michigan, Ann Arbor, Michigan
    • ,
  • Peter A. Ubel

      Affiliations

    • VA Health Services Research and Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
    • Division of General Medicine, University of Michigan, Ann Arbor, Michigan
    • ,
  • Rodney A. Hayward

      Affiliations

    • VA Health Services Research and Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
    • Division of General Medicine, University of Michigan, Ann Arbor, Michigan

Received 22 May 2008 ,Accepted 7 August 2008.

References 

  1. IOM. Organ procurement and transplantation: assessing current policies and the impact of the DHHS final rule. Washington, DC: National Academies Press; 2000;
  2. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–470
  3. Ubel PA, Loewenstein G. Distributing scarce livers: the moral reasoning of the general public. Soc Sci Med. 1996;42:1049–1055
  4. Merion RM, Schaubel DE, Dykstra DM, et al. The survival benefit of liver transplantation. Am J Transplant. 2005;5:307–313
  5. Feng S, Goodrich NP, Bragg-Gresham JL, et al. Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transplant. 2006;6:783–790
  6. Segev DL, Maley WR, Simpkins CE, et al. Minimizing risk associated with elderly liver donors by matching to preferred recipients. Hepatology. 2007;46:1907–1918
  7. Avolio AW, Agnes S, Gasbarrini A, et al. Allocation of nonstandard livers to transplant candidates with high MELD scores: should this practice be continued?. Transplant Proc. 2006;38:3567–3571
  8. Amin MG, Wolf MP, TenBrook JA, et al. Expanded criteria donor grafts for deceased donor liver transplantation under the MELD system: a decision analysis. Liver Transpl. 2004;10:1468–1475
  9. Schaubel DE, Sima CS, Goodrich NP, et al. The survival benefit of deceased donor liver transplantation as a function of candidate disease severity and donor quality. Am J Transplant. 2008;8:419–425
  10. UNOS. Policy 3.6, organ distribution: allocation of livers. Richmond, VA: UNOS; 2006;
  11. Allison PD. Missing data. Thousand Oaks, CA: Sage Publications; 2002;
  12. Roberts JP, Dykstra DM, Goodrich NP, et al. Geographic differences in event rates by model for end-stage liver disease score. Am J Transplant. 2006;6:2470–2475
  13. Biggins SW, Bambha K. MELD-based liver allocation: who is underserved?. Semin Liver Dis. 2006;26:211–220
  14. MacKinnon DP, Fairchild AJ, Fritz MS. Mediation analysis. Annu Rev Psychol. 2007;58:593–614
  15. Maluf DG, Edwards EB, Kauffman HM. Utilization of extended donor criteria liver allograft: is the elevated risk of failure independent of the model for end-stage liver disease score of the recipient?. Transplantation. 2006;82:1653–1657
  16. Rodriguez-Luna H, Vargas HE, Moss A, et al. Regional variations in peer reviewed liver allocation under the MELD system. Am J Transplant. 2005;5:2244–2247
  17. Bravata DM, Olkin I, Barnato AE, et al. Health-related quality of life after liver transplantation: a meta-analysis. Liver Transpl Surg. 1999;5:318–331
  18. Ratcliffe J, Longworth L, Young T, et al. Assessing health-related quality of life pre- and post-liver transplantation: a prospective multicenter study. Liver Transpl. 2002;8:263–270
  19. Saab S, Ibrahim AB, Shpaner A, et al. MELD fails to measure quality of life in liver transplant candidates. Liver Transpl. 2005;11:218–223
  20. Kanwal F, Hays RD, Kilbourne AM, et al. Are physician-derived disease severity indices associated with health-related quality of life in patients with end-stage liver disease?. Am J Gastroenterol. 2004;99:1726–1732
  21. Axelrod DA, Schnitzler M, Salvalaggio PR, et al. The economic impact of the utilization of liver allografts with high donor risk index. Am J Transplant. 2007;7:990–997
  22. Foley DP, Fernandez LA, Leverson G, et al. Donation after cardiac death: the University of Wisconsin experience with liver transplantation. Ann Surg. 2005;242:724–731
  23. Redelmeier DA, Shafir E. Medical decision making in situations that offer multiple alternatives. JAMA. 1995;273:302–305
  24. Gilovich T, Griffin DW, Kahneman D. Heuristics and biases: the psychology of intuitive judgement. Cambridge, UK: Cambridge University Press; 2002;
  25. Cialdini RB. Influence: science and practice. 4th ed.. Boston, MA: Allyn and Bacon; 2001;
  26. Axelrod DA, Koffron AJ, Baker T, et al. The economic impact of MELD on liver transplant centers. Am J Transplant. 2005;5:2297–2301
  27. Jones IR, Berney L, Kelly M, et al. Is patient involvement possible when decisions involve scarce resources? (A qualitative study of decision-making in primary care). Soc Sci Med. 2004;59:93–102
  28. Workgroup on expanded criteria organs for liver transplantation. Liver Transpl. 2005;11:1184–1192
  29. Ross LF, Zenios S, Thistlethwaite JR. Shared decision making in deceased-donor transplantation. Lancet. 2006;368:333–337

 The authors disclose no financial conflicts.

 This work was supported in part by a grant from the Robert Wood Johnson Foundation and the Department of Veterans Affairs (to M.L.V.), and by Health Resources and Services Administration contract 234-2005-370011C (United Network for Organ Sharing).

 The content is the responsibility of the authors alone, and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The sponsors had no role in design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.

PII: S0016-5085(08)01508-4

doi: 10.1053/j.gastro.2008.08.003

Gastroenterology
Volume 135, Issue 5 , Pages 1568-1574 , November 2008

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