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  • Title: Waiting list outcome of Peld/Meld exceptions: A single-center experience in Argentina.
    Author: Lauferman L, Dip M, Halac E, Cervio G, Aredes D, Capparelli M, Reijenstein H, Minetto J, Rojas L, Goñi J, Jacobo Dillon A, Martinitto R, Imventarza O.
    Journal: Pediatr Transplant; 2018 Mar; 22(2):. PubMed ID: 29297966.
    Abstract:
    As PELD/MELD-based allocation policy was adopted in Argentina in 2005, a system of exception points has been in place in order to award increased waitlist priority to those patients whose severity of illness is not captured by the PELD/MELD score. We aimed to investigate the WL outcome of patients with granted PELD/MELD exceptions. A retrospective cohort study was conducted in children under 18 years old. WL outcomes were evaluated using univariable analysis. From 07/2005 to 01/2014, 408 children were listed for LT. There were 304 classified by calculated PELD/MELD. During this time, 85 (30%) PELD/MELD exceptions were granted. In this cohort, 89.4% (76 of 85) were transplanted and 7.1% (6 of 85) died while on the WL. The remaining 3 pts (3.5%) were removed from the WL due to other causes. We compared the impact of PELD/MELD exceptions in those 85 patients to outcomes in 87 non-exception patients with PELD/MELD ≥19 points. Patients with the exception had significantly better access to WL and lower WL mortality. Our data suggest that children listed by PELD/MELD exceptions had an advantage compared to children with CLD with equivalent PELD/MELD listing priorities.
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