Awarding additional MELD points to the shortest waitlist candidates improves sex disparity in access to liver transplant in the United States

Recorded live on Tuesday, October 25th, 2022 • Hosted jointly by AST's Liver and Intestinal Community of Practice (LICOP) and Women's Health Community of Practice (WHCOP)

"Awarding additional MELD points to the shortest waitlist candidates improves sex disparity in access to liver transplant in the United States"
(Am J Transplant. 2022 Jul 24. doi: 10.1111/ajt.17159.)

In this article:
Since the introduction of the MELD-based allocation system, women are now 30% less likely than men to undergo liver transplant (LT) and have 20% higher waitlist mortality. These disparities are in large part due to height differences in men and women though no national policies have been implemented to reduce sex disparities. Patients were identified using the Scientific Registry of Transplant Recipients (SRTR) from 2014 to 2019. Patients were categorized into five groups... [The authors] identified two proposed policy changes to LSAM scenarios that resulted in improvement in LT and death percentage for the shortest candidates with the least negative impact on taller candidates. In conclusion, awarding an additional 1–2 MELD points to the shortest 8% of LT candidates would improve waitlist outcomes for women.

- Neil Mehta, MD • University of California San Francisco, San Francisco, CA

- Sarah Bernards, MD • University of Washington, Seattle, WA

- Alexandra Shingina, MD, MSc • Vanderbilt University Medical Center, Nashville, TN
- Hyosun (Helen) Han, MD • University of Southern California Keck School of Medicine, Los Angeles, CA

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