Re: Fw: [TRNSPLNT] 9.05.2008

[Guest guest]

Please do not pay any attention to this news paper clip. I was called

by this author and told him my story and he changed my words all

around. I would not have changed anything that I have done in the

past. I got my liver at score of 16 yes this is low but I was in

great shape to pull through the operation easier. There are risk to

any surgery but I needed a transplant and there was nothing that

anyone could have done for that. Plus quality of life is VERY

important with itching, fatigue, hurting, depression, all of these

make the decision that the doctors make not me. If you are going to

post a article you should post the whole thing. Thanks Ken

> Don     

> Please be a blood/organ donor

>

>

>

> From: michael thomas

> Subject: [TRNSPLNT] 9.05.2008

> To: TRNSPLNT@...

> Date: Friday, September 5, 2008, 11:08 AM

>

> 9.05.2008

> Adjusting Scoring System for Liver Transplant Could make System more

> Equitable

>

>

> Scoring fix urged for liver patients

> By Fabregas

>

> Friday, September 5, 2008

>

> Some patients at the bottom of liver transplant waiting lists could

> get organs faster with a modest change to the scoring system that

> prioritizes patients on the lists, according to research published

> Thursday in the New England Journal of Medicine.

>

> The system, which ranks patients based on three factors, could be

> improved by adding a fourth test that measures levels of serum sodium

> -- an indicator of severe sickness in a key group of liver patients,

> the researchers from Mayo Clinic reported.

>

> " The data pretty strongly indicates that this could save lives, " said

> Dr. W. Ray Kim, the study's lead author and a hepatologist at Mayo

> Clinic's campus in Rochester, Minn.

>

> Altering the allocation system known as MELD, which stands for Model

> for End Stage Liver Disease, was one of several options proposed by

> experts after a Tribune-Review investigation this year that showed

> some patients get liver transplants when they don't need them.

>

> The three-day series showed patients at the lower end of the MELD

> scale -- ranging from 6 for the least ill to 40 for those at greater

> risk of death -- often get transplants when they could have lived

> longer without them.

>

> Doctors have specifically advocated tweaking the MELD score by adding

> the serum sodium test, a factor that is being examined by the United

> Network for Organ Sharing, the federal agency that manages the organ

> allocation system.

>

> " We are aware of the value of sodium, " said Dr. Washburn, co-

> chairman of the UNOS liver committee and a transplant surgeon at the

> University of Texas Health Science Center.

>

> The UNOS committee, emboldened by the Trib series, has been working to

> improve the liver allocation system at a time when more than 16,000

> patients are on the waiting list. In July, the committee voted to move

> forward a proposal to implement a wider, regional sharing plan. It

> would make livers available first to the sickest patients within a

> wider geographic area rather than local delineations.

>

> But even if given final approval, that system would use the 6-year-old

> MELD system, which ranks patients based on three blood tests that do

> not include serum sodium.

>

> The serum sodium test has been particularly effective in predicting

> death among patients with cirrhosis, a chronic illness that causes

> scar tissue to build in the liver, Kim said.

>

> Low levels of serum sodium indicate severe illness in some patients

> who would otherwise have low MELD scores. Those patients almost always

> are afflicted by a condition known as ascites, in which fluid builds

> up in the abdomen. Nonetheless, they get stuck at the bottom of

> waiting lists, Kim said.

>

> The Mayo Clinic researchers created a statistical model using 2005

> data provided by UNOS. Using the model, researchers analyzed data from

> 2006, when 477 patients died within three months of being listed for a

> liver transplant.

>

> Using the serum sodium factor showed that 7 percent of those patients

> would have received higher priority for a transplant, perhaps

> preventing their deaths.

> source: (Pittsburgh Tribune-Review)

>

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>

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