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Mayo Clinic Proceedings Contributors Discuss Impact of Donor Organ Allocation System
Date:2/6/2008

ROCHESTER, Minn., Feb. 6 /PRNewswire-USNewswire/ -- Liver transplant is a life saving treatment option for people with end-stage liver disease. Unfortunately, the need for donor livers far exceeds the supply. Each year only about one-third of people who need a donor liver will receive one, and some patients die while waiting. In the February issue of Mayo Clinic Proceedings, physicians explore how the current system for allocating donor organs in the United States affects outcomes for patients with end-stage liver disease.

In the United States, the United Network for Organ Sharing (UNOS) oversees the allocation of donor organs. With the goal of giving available donor organs to the most critically-ill transplant candidates, UNOS adopted a scoring system called the Model for End-Stage Liver Disease (MELD) in February 2002. Unlike past evaluation systems, the MELD score de-emphasizes the length of time a patient has been waiting for a donor organ.

A patient's MELD score is calculated from the results of three laboratory tests. Scores range between 6 and 40, with higher numbers reflecting a more urgent need for transplantation. Research has shown that although the donor liver shortage persists, implementing this allocation system has decreased the number of patients who die while waiting for donor organs.

"Early referral to a liver transplant center no longer provides an advantage for organ allocation. However, it is unclear whether it offers other advantages, or if alternative strategies should be developed regarding timing of referral for liver transplant," writes Jaime Aranda-Michel, M.D., a member of the Mayo Clinic Jacksonville liver transplant team and lead researcher for a Mayo study on this topic.

The Mayo study examined the evaluation practices and denial and acceptance criteria for liver transplant used by the Mayo Clinic Jacksonville Transplant Center after the MELD system was implemented.

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