"Beyond MELD" - Emerging strategies and technologies for improving mortality prediction, organ allocation and outcomes in liver transplantation - PubMed (original) (raw)

Review

"Beyond MELD" - Emerging strategies and technologies for improving mortality prediction, organ allocation and outcomes in liver transplantation

Jin Ge et al. J Hepatol. 2022 Jun.

Abstract

In this review article, we discuss the model for end-stage liver disease (MELD) score and its dual purpose in general and transplant hepatology. As the landscape of liver disease and transplantation has evolved considerably since the advent of the MELD score, we summarise emerging concepts, methodologies, and technologies that may improve mortality prognostication in the future. Finally, we explore how these novel concepts and technologies may be incorporated into clinical practice.

Keywords: Allocation; Clinical Decision Support; EHR; Frailty; MELD; OMOP; Prognostication; Sarcopenia.

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Conflict of interest statement

Conflict of interest The authors of this manuscript have no conflicts of interest to disclose as described by the Journal of Hepatology. Please refer to the accompanying ICMJE disclosure forms for further details.

Figures

Fig. 1.. Rapid-cycle testing in ‘electronic’ randomised controlled trials.

Schematic of rapid-cycle ‘electronic’ randomised controlled trials could be implemented using CDS systems: computational risk assessment allows a patient to be randomised for an intervention associated with a CDS, the results of which could then be used to iteratively modify the risk stratification algorithm or the CDS system. CDS, clinical decision support.

Comment in

Towards optimally replacing the current version of MELD.
Kartoun U. Kartoun U. J Hepatol. 2023 Mar;78(3):e98-e99. doi: 10.1016/j.jhep.2022.07.013. Epub 2022 Jul 20. J Hepatol. 2023. PMID: 35870703 No abstract available.
Response to: "Towards optimally replacing the current version of MELD".
Ge J, Kim WR, Lai JC, Kwong AJ. Ge J, et al. J Hepatol. 2023 Mar;78(3):e100-e101. doi: 10.1016/j.jhep.2022.11.008. Epub 2022 Nov 17. J Hepatol. 2023. PMID: 36402449 No abstract available.

References

1. Organ Procurement and Transplantation Network (OPTN). Final Rule as revised by amendments. 1999.
1. Jochmans I, van Rosmalen M, Pirenne J, Samuel U. Adult liver allocation in eurotransplant. Transplantation 2017;101:1542–1550. 10.1097/TP.0000000000001631. -DOI -PubMed
1. Goudsmit BFJ, Putter H, Tushuizen ME, Vogelaar S, Pirenne J, Alwayn IPJ, et al. Refitting the model for end-stage liver disease for the eurotransplant region. Hepatology 2021;74:351–363. 10.1002/hep.31677. -DOI -PMC -PubMed
1. Trotter JF. Liver transplantation around the world. Curr Opin Organ Transpl 2017;22:123–127. 10.1097/MOT.0000000000000392. -DOI -PubMed
1. Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology 2003;124:91–96. 10.1053/gast.2003.50016. -DOI -PubMed

"Beyond MELD" - Emerging strategies and technologies for improving mortality prediction, organ allocation and outcomes in liver transplantation - PubMed (original) (raw)