TY - JOUR
T1 - Effect of minimal listing criteria on waiting list registration for liver transplantation
T2 - A process-outcome analysis
AU - Talwalkar, Jayant A.
AU - Kim, W. Ray
AU - Rosen, Charles B.
AU - Kamath, Patrick S.
AU - Wiesner, Russell H.
N1 - Funding Information:
This study was supported in part by an American Association for the Study of Liver Diseases (AASLD)/Schering Advanced Hepatology Award to Dr Talwalkar.
PY - 2003/4/1
Y1 - 2003/4/1
N2 - Objective: To determine the level of association between minimal listing criteria (MLC) recognition and outcomes associated with waiting list registration for liver transplantation (LT). Patients and Methods: A total of 147 patients and 201 patients were identified as first-time referrals for LT evaluation between January 1, 1997, and November 30, 1997 (cohort A), and December 1, 1997, and December 31, 1998 (cohort B), respectively. Relevant demographic and clinical information was abstracted from medical records. Minimal listing criteria were defined as a Child-Turcotte-Pugh (CTP) score of 7 or higher. Results: Patient age, sex, hepatic disease etiology, and mean CTP scores were similar between cohorts A and B. However, the proportion of registered patients in cohort B with CTP scores of 7 or higher increased significantly after formal MLC recognition (96% vs 82% for cohort A; P=.001). In cohort A, waiting list registration was based on patient age, male sex, nonalcohol-related hepatic disease, and a CTP score of 7 or higher in the absence of formal MLC. The rate of first-time patient referral was also increased in cohort B vs cohort A after formal MLC recognition (80% vs 69%, respectively; P=.002) despite similar clinical characteristics. Although the number of patients with a CTP score of 10 or higher was greater in cohort B vs cohort A, the proportion of patients with advanced endstage liver disease was similar (29% vs 26%, respectively; P=.72). Conclusion: The explicit recognition of MLC was strongly associated with improvements in appropriate waiting list registration for LT.
AB - Objective: To determine the level of association between minimal listing criteria (MLC) recognition and outcomes associated with waiting list registration for liver transplantation (LT). Patients and Methods: A total of 147 patients and 201 patients were identified as first-time referrals for LT evaluation between January 1, 1997, and November 30, 1997 (cohort A), and December 1, 1997, and December 31, 1998 (cohort B), respectively. Relevant demographic and clinical information was abstracted from medical records. Minimal listing criteria were defined as a Child-Turcotte-Pugh (CTP) score of 7 or higher. Results: Patient age, sex, hepatic disease etiology, and mean CTP scores were similar between cohorts A and B. However, the proportion of registered patients in cohort B with CTP scores of 7 or higher increased significantly after formal MLC recognition (96% vs 82% for cohort A; P=.001). In cohort A, waiting list registration was based on patient age, male sex, nonalcohol-related hepatic disease, and a CTP score of 7 or higher in the absence of formal MLC. The rate of first-time patient referral was also increased in cohort B vs cohort A after formal MLC recognition (80% vs 69%, respectively; P=.002) despite similar clinical characteristics. Although the number of patients with a CTP score of 10 or higher was greater in cohort B vs cohort A, the proportion of patients with advanced endstage liver disease was similar (29% vs 26%, respectively; P=.72). Conclusion: The explicit recognition of MLC was strongly associated with improvements in appropriate waiting list registration for LT.
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U2 - 10.4065/78.4.431
DO - 10.4065/78.4.431
M3 - Article
C2 - 12683695
AN - SCOPUS:0037382473
SN - 0025-6196
VL - 78
SP - 431
EP - 435
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 4
ER -