Online Program Home
My Program

Abstract Details

Activity Number: 696
Type: Contributed
Date/Time: Thursday, August 4, 2016 : 10:30 AM to 12:20 PM
Sponsor: Section on Statistics in Epidemiology
Abstract #320832 View Presentation
Title: Projected Outcomes of Six-Month Delay in Exception Points vs. an Equivalent MELD Score for HCC Liver Transplant Candidates
Author(s): Guy N. Brock* and Douglas J. Lorenz and Sarah K. Alver and Michael R. Marvin
Companies: The Ohio State University and University of Louisville and University of Louisville and Geisinger Medical Center
Keywords: multistate models ; waitlist dropout ; waitlist prioritization ; hepatocellular carcinoma ; outcome prediction ; equivalent MELD score

To address the disparity in transplantation access between hepatocellular carcinoma (HCC) and non-HCC patients, the United Network for Organ Sharing (UNOS) recently implemented a six-month delay before granting exception points to liver transplant candidates with HCC. As an alternative to the six-month delay, an HCC-specific scoring scheme called the Model for End-Stage Liver Disease Equivalent (MELDEQ) has also been developed. To assess which prioritization scheme would result in more equitable outcomes, we compared projected dropout and transplant probabilities for HCC and non-HCC patients under the six-month delay and the MELDEQ using causal inference and multistate modeling methods with recent UNOS data. Projections under the MELDEQ and the six-month delay were similar during the first six months on the waitlist. However, reverting back to scheduled exception point progression after six months still advantaged HCC patients. Projections under the MELDEQ for patients on the waitlist after six months showed more equitable transplant probabilities and decreased dropout for non-HCC patients, but increased dropout for HCC patients with MELDEQ scores < 22.

Authors who are presenting talks have a * after their name.

Back to the full JSM 2016 program

Copyright © American Statistical Association