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Benjamin Philosophe, MD, PhD; Stephen T. Bartlett, MD

Arch Surg. 2007;142(11):1086.

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Austin et al present an analysis that evaluated the impact of the MELD-based allocation policy on access to liver transplantation and posttransplantation outcomes. They used a statistical method based on a large national database that accounts for seasonal trends. Their primary end point was to establish whether the DHHS directive of decreasing waiting list mortality was achieved as a result of MELD implementation. The authors used the 1999-2004 Organ Procurement and Transplantation Network files, which permitted collection of more than 2 years of time points before and after the February 27, 2002, MELD intervention. Their model revealed a steady postintervention decline in waiting list mortality by 0.09 death per 1000 registrants per month after an initial increase of 2.2 deaths per 1000 registrants per month after MELD implementation. Between March 1999 and February 2002, a 3% decline in the death rate occurred, . . . [Full Text of this Article]

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Model for End-stage Liver Disease: Did the New Liver Allocation Policy Affect Waiting List Mortality?
Mary T. Austin, Benjamin K. Poulose, Wayne A. Ray, Patrick G. Arbogast, Irene D. Feurer, and C. Wright Pinson
Arch Surg. 2007;142(11):1079-1085.
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