MELD is MELD is MELD? Transplant center-level variation in waitlist mortality for candidates with the same biological MELD.

ABSTRACT: Recently, model for end-stage liver disease (MELD)-based liver allocation in the United States has been questioned based on concerns that waitlist mortality for a given biologic MELD (bMELD), calculated using laboratory values alone, might be higher at certain centers in certain locations across the country. Therefore, we aimed to quantify the center-level variation in bMELD-predicted mortality risk. Using Scientific Registry of Transplant Recipients (SRTR) data from January 2015 to December 2019, we modeled mortality risk in 33 260 adult, first-time waitlisted candidates from 120 centers using multilevel Poisson regression, adjusting for sex, and time-varying age and bMELD. We calculated a "MELD correction factor" using each center's random intercept and bMELD coefficient. A MELD correcti

SUBMITTER: Ishaque T 

PROVIDER: S-EPMC11537497 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature