8/17/2023 0 Comments Meld score mortalityBaseline findings from physical examination (PE), laboratory test results, ultrasound report of the hepatobiliary system, and cause of death (in dead cases) were extracted from the medical records of patients and transferred into the checklist by the GP. The data were taken from patients in the first visit based on self-report. A comprehensive checklist, consisting of baseline demographic and socio-economic characteristics, patient health self-assessment, a history of cigarette or hookah smoking, alcohol drinking, drug use, diabetes mellitus (DM), hypertension (HTN), hyperlipidemia, asthma, gastrointestinal (GI) diseases, kidney diseases, and cancer, was completed for each subject. The first assessment of patients was performed at Shiraz Organ Transplantation Center in patients presence, but the next follow-ups were carried out based on medical records through phone calls with patients or their first-degree relatives (in cases of dead patients). The current study protocol was approved by the Ethics Committee of Shiraz University of Medical Sciences (SUMS) (ethical code: IR.1000).įor data gathering, a trained team, including a general practitioner (GP), a nutritionist, and two public health graduates, were recruited. The participants’ privacy was assured, including interview and gathering, recording, analysis, and reporting of data. All subjects provided written informed consent after enrollment, while voluntary participation was respected in all stages of the study. They were registered as candidates for LT by a multidisciplinary team consisted of transplantation surgeons, hepatologists, pathologists, radiologists, and nutritionists. The subjects had been referred to the Shiraz Organ Transplant Center from different regions of Iran. The current prospective cohort study, after excluding patients not providing consent to participate in the research, was conducted on 544 adult patients with ESLD, aged ≥ 18 years. The current study aimed at assessing the predictors of mortality in LT candidates in a more comprehensive manner with possible implications to improve the care of such patients and assist in developing better strategies for organ allocation. The Child-Turcotte-Pugh (CTP) and the model for end-stage liver disease (MELD) were introduced to predict the outcome in patients on WL of LT ( 7, 8) however, several studies revealed that these scores alone are insufficient, and there is a great need to consider other predictive factors of mortality in them ( 7, 9). Moreover, the demand-supply imbalance caused a long waiting list (WL) in many centers ( 5, 6), resulting in the death of a significant proportion of such patients before having a chance to receive transplants ( 5). As a result, demand increases for liver transplantation (LT), the most effective treatment for end-stage liver disease (ESLD) ( 3, 4). Backgroundĭisability-adjusted life years (DALYs) and deaths caused by cirrhosis and chronic liver diseases increased worldwide by 37.9% and 46% from 1990 to 2016, respectively ( 1, 2). Survival Waiting List Liver Transplantation Cirrhosis, End-stage Liver Disease 1. In addition to MELD score, HPS, a history of MI, low CHO intake, weight loss, ascites, PMN, CA 125, ALT, hepatitis B surface antigen, MCV, blood urea nitrogen, and gallbladder wall thickness are predictors of mortality in LT candidates and need to be considered in the LT allocation system.
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