Re: transplant criteria

[Guest guest]

--- Baudoux-Northrup wrote:

> This is just rhetorical, but why is it that the labs

> have to be bad to upgrade, I would think the

> infections would play a significant role in moving up.

>

UNOS bases the transplant criteria on indications of liver

failure, not just something going on with the liver. Thus

clotting time (INR), albumin, bilirubin, ascites and

encephalopathy are used (under the current scheme, the MELD

score has some different measures), but not AST, ALT, Alk Phos,

etc. because the later do not indicate liver failure, just

current damage to the liver.

Cholangitis is not by itself a reason to transplant - it can be

treated with antibiotics. Even bleeds don't automatically change

your status. They are factors that can be taken into account

when the transplant team seeks a change of status, but it is an

appeal with these things as justification, not an automatic

change.

To use an automotive analogy, if you blow a heater hose you

don't replace the car or engine, you fix the hose. If the engine

seizes up you think about car or engine replacement. But there

is also a point where all the little things add up to decision

for replacement too. UNOS rules are based on total failure but

allow adjustments due to other factors.

Unfortunately replacement livers are in short supply, about 12

become available every day in the US. But 16 people need those

12 livers and 4 will never get one.

Tim R

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[Guest guest]

Well now, if I were on the UNOS board, we all would

get new livers....doctors would get rich from all the

surgeries.

I can't even show that note to Mike, geeze, he would

throw that in my face everytime I talked abou a new

car. I have had this green one for one full year now

and it does have 20,000 miles on it, and the floor

mats are getting full of dirt. A blue car would be

nice..........just kidding.