Transplant Trial Watch

Refitting the Model for End-stage Liver Disease for the Eurotransplant region.

Hepatology 2020 [record in progress].

Goudsmit, B. F. J., et al.


Aims
This study aimed to establish a refit model for end-stage liver disease (reMELD) score for the Eurotransplant region.

Interventions
Patient data were randomly divided into a training set and a validation set.

Participants
6944 patients listed for a first liver transplant.

Outcomes
The primary endpoint was patient death during 90 days of first active listing, including both actively listed and removed patients.

Follow-up
90 days

CET Conclusions
This is a very interesting report detailing the work done to re-fit the UNOS-MELD for the European population and using a modern cohort. All adult patients listed in an 11-year period were included (6,944), with 70% being used for training and 30% for validation. The primary outcome was death within 90 days of listing. Importantly, removed patients that died within 90 days were included in the analysis. The reweighted parameters performed significantly better in the validation cohort than the previous MELD model, resulting in greater “sickest-first” allocation.

Trial registration
N/A

Funding source
No funding received