Guest guest Posted November 26, 2008 Report Share Posted November 26, 2008 True,PSE patients get the shaft by thr MELD. The Meld will not cosiders the horrors of full blown, body-wide, 24/4 pruritis (horrible intternal itching) as an exception. These patients may never get a transplant because the MELD considers uncurable pruritis as a quality of life matter. The reason that I can see for a higher transplant rate for males, is that men drink more. > > > > > > _________________________________________________________________ > Windows Live Hotmail now works up to 70% faster. > http://windowslive.com/Explore/Hotmail? ocid=TXT_TAGLM_WL_hotmail_acq_faster_112008 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 27, 2008 Report Share Posted November 27, 2008 The written report, " Disparities in Liver Transplant Allocation Shift but Still Exist " , at: http://www.medpagetoday.com/Gastroenterology/LiverTransplantation/11918 speculates that the reason is that women are at a disadvantage because of their generally smaller size than men. They write, " because women have less body mass, the inclusion of creatinine rather than weight-adjusted glomerular filtration rate in the MELD score is likely to underestimate their degree of renal dysfunction. " Also, small livers are prioritized for pediatric transplantation and although a small liver may be used for a large person, large liver are not appropriate for a person with a small build. So on average fewer are available for transplantion in women. I disagree that PSCers are at a disadvantage with MELD. The statistic don't support that statement. The death rate for those on the waiting list for cholestatic liver disease (mostly PSC and PBC) is much below average (77.1 vs 116.8 per 1,000 Patient-Years at Risk in 2006). Lower than any other diagnostic category except biliary atresia. It is true that pruritis is not taken into account by the MELD score, but all liver disease patients are at risk of suffering from pruritis. It is not just a PSC problem. And once we receive a transplant our survival is among the best of all the diagnostic categories. (See Reported Deaths on Liver Waiting List at http://www.optn.org/AR2007/903_can-dgn_li.htm). Tim R Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.