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Female Liver Transplant Recipients with the Same GFR as Male Recipients Have Lower MELD Scores—A Systematic Bias

Cholongitas, E. ; Marelli, L. ; Kerry, A. ; Goodier, D. W. ; Nair, D. ; Thomas, M. ; Patch, D. ; Burroughs, A. K.

American journal of transplantation, 2007-03, Vol.7 (3), p.685-692 [Periódico revisado por pares]

Oxford, UK: Blackwell Publishing Ltd

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Título:
Female Liver Transplant Recipients with the Same GFR as Male Recipients Have Lower MELD Scores—A Systematic Bias
Autor: Cholongitas, E. ; Marelli, L. ; Kerry, A. ; Goodier, D. W. ; Nair, D. ; Thomas, M. ; Patch, D. ; Burroughs, A. K.
Assuntos: Adult ; Aged ; Aged, 80 and over ; Bias ; Biological and medical sciences ; Creatinine ; Creatinine - blood ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; gender ; GFR ; Glomerular Filtration Rate ; Humans ; Kidney Function Tests ; Liver Failure - diagnosis ; Liver Failure - surgery ; Liver Transplantation ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; MELD score ; Middle Aged ; Models, Biological ; Other diseases. Semiology ; Severity of Illness Index ; Sex Factors ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Waiting Lists
É parte de: American journal of transplantation, 2007-03, Vol.7 (3), p.685-692
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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Descrição: Women have lower glomerular filtration (GFR) than men for the same serum creatinine (Cr) value, not accounted for in model for end‐stage liver disease (MELD). We compare male/female Cr, GFR (using MDRD formula) and respective MELD scores in 403 Cr measurements using standard (sCr), O'Leary modified (mCr) and Compensated (cCr) Jaffe and Enzymatic (eCr) in 158 liver disease patients, mCr in 208 liver transplantation (LT) candidates, and EDTA‐Cr51‐GFR in 38 other candidates for LT; considering each female as male, a ‘corrected’ Cr was derived. MELD scores were calculated for measured and ‘corrected’ Cr in females. Median Cr and GFR in females were lower than males (p < 0.05). Both MDRD and EDTA‐Cr51 GFR were lower in females than males, despite lower Cr values. In females, each MELD score was lower than the corresponding MELD–corrected Cr (p < 0.001) with ≥three‐point difference in liver disease patients: 25%[sCr]; 23%[mCr]; 11%[eCr]; and 14%[cCr]. In 65% of female LT candidates, two‐ or three‐point difference was found. Females with liver disease have lower GFR than males for the same Cr value; correcting Cr increases MELD score by two or three points in 65% of female LT candidates. MELD score adjustment in females would ensure equal LT priority by gender. The failure to accurately estimate the male‐female difference in GFRs in calculating the MELD scores may operate as a bias against females in liver transplant allocation.
Editor: Oxford, UK: Blackwell Publishing Ltd
Idioma: Inglês

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Female Liver Transplant Recipients with the Same GFR as Male Recipients Have Lower MELD Scores—A Systematic Bias

Cholongitas, E. ; Marelli, L. ; Kerry, A. ; Goodier, D. W. ; Nair, D. ; Thomas, M. ; Patch, D. ; Burroughs, A. K.

Oxford, UK: Blackwell Publishing Ltd

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