First National Report After the Implementation of the Meld-Based Allocation System for Liver Transplantation in Argentina

Abstract

Background: In July 2005, Argentina was the first country that followed US in adopting the MELD-based allocation system for patients requiring liver transplantation. So far, this policy is not internationally validated. The aim of this study is to analyze the impact of the adoption of MELD-based allocation system for elective patients on the liver waiting list. Methods: Between July 2005 and April 2009, 1773 adult patients were included in the waiting list: 150 emergencies and 1623 electives. Elective patients were categorized under the MELD system. Using a prospective collected national database, we analyzed this cohort of patients regarding mortality and probability to be transplanted. Results: The median waiting time increased inversely with the MELD score and the probability to receive a LT positively correlated with patient MELD score. With scores ≥18 the probability to receive a liver remained over 50%. However, the largest MELD category with <10 points (n: 433) had the lower probability to be transplanted (3%) among all categories. In contrast, patients with T2 hepatocellular