The Model for End-Stage Liver Disease (MELD) score has been used since 2002.
MELD is used to allocate livers for transplantation from deceased donors according to medical need.
Allocation based on MELD scores should ensure that sicker patients receive transplants first regardless of transplantation center volume.
Dr Jawad Ahmad and colleagues from Pennsylvania determined whether the MELD score and waiting time of liver transplant recipients differs by transplantation center volume.
The research team analyzed the Organ Procurement and Transplantation Network database of transplant centers in the USA.
|High-volume centers have shorter waiting times|
|Annals of Internal Medicine|
Centers were classified according to the volume of transplantations performed in 2005.
The team classified 100 transplantations as high, 50 to 99 as medium, and less than 50 as low volume centers.
The researchers identified 20,075 transplant recipients between 2002 and 2006.
The team found that transplant recipients at high-volume centers had lower MELD scores.
The median MELD score was 22 in high-volume centers compared with 24 at both medium- and low-volume centers.
Despite having lower MELD scores, the team observed that recipients at high-volume centers also experienced shorter waiting times.
The team highlight that the recent implementation of MELD precluded analysis of differences in long-term outcomes related to waiting time or center volume.
Dr Ahmad's team concludes, "The MELD scores and waiting time of liver transplant recipients differed by transplantation center volume."
"High-volume centers have shorter waiting times and perform more transplantations for less sick patients."
"The reasons for these differences are unclear but warrant further investigation."