{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:44:31Z","timestamp":1793119471331,"version":"4.5.0"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,8,29]],"date-time":"2021-08-29T00:00:00Z","timestamp":1630195200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Patients with cirrhosis on the liver transplant (LT) waiting list may die or be removed because of complications of portal hypertension (PH) or infections. von Willebrand factor antigen (vWF\u2010Ag) and C\u2010reactive protein (CRP) are simple, broadly available markers of these processes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>We determined whether addition of vWF\u2010Ag and CRP to the Model for End\u2010Stage Liver Disease\u2010Sodium (MELD\u2010Na) score improves risk stratification of patients awaiting LT. CRP and vWF\u2010Ag at LT listing were assessed in two independent cohorts (Medical University of Vienna [exploration cohort] and Mayo Clinic Rochester [validation cohort]). Clinical characteristics, MELD\u2010Na, and mortality on the waiting list were recorded. Prediction of 3\u2010month waiting list mortality was assessed by receiver operating characteristics curve (ROC\u2010AUC). In order to explore potential mechanisms underlying the prognostic utility of vWF\u2010Ag and CRP in this setting, we evaluated their association with PH, bacterial translocation, systemic inflammation, and circulatory dysfunction. In the exploration cohort (n\u00a0=\u00a0269) vWF\u2010Ag and CRP both improved the predictive value of MELD\u2010Na for 3\u2010month waitlist mortality and showed the highest predictive value when combined (AUC: MELD\u2010Na, 0.764; MELD\u2010Na + CRP, 0.790; MELD\u2010Na + vWF, 0.803; MELD\u2010Na + CRP + vWF\u2010Ag, 0.824). Results were confirmed in an independent validation cohort (n\u00a0=\u00a0129; AUC: MELD\u2010Na, 0.677; MELD\u2010Na + CRP + vWF\u2010Ag, 0.882). vWF\u2010Ag was independently associated with PH and inflammatory biomarkers, whereas CRP closely, and MELD independently, correlated with biomarkers of bacterial translocation\/inflammation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The addition of vWF\u2010Ag and CRP\u2014reflecting central pathophysiological mechanisms of PH, bacterial translocation, and inflammation, that are all drivers of mortality on the waiting list for LT\u2014to the MELD\u2010Na score improves prediction of waitlist mortality. Using the vWFAg\u2010CRP\u2010MELD\u2010Na model for prioritizing organ allocation may improve prediction of waitlist mortality and decrease waitlist mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31838","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T04:01:51Z","timestamp":1617163311000},"page":"1533-1545","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":25,"title":["The Addition of C\u2010Reactive Protein and von Willebrand Factor to Model for End\u2010Stage Liver Disease\u2010Sodium Improves Prediction of Waitlist Mortality"],"prefix":"10.1097","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4666-5337","authenticated-orcid":false,"given":"Patrick","family":"Starlinger","sequence":"first","affiliation":[{"name":"Department of Surgery,Division of Hepatobiliary and Pancreas Surgery,Mayo Clinic,Rochester,MN"},{"name":"Department of Surgery,Division of General Surgery,Medical University of Vienna,General Hospital Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph C.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan","family":"Mullan","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0863-2876","authenticated-orcid":false,"given":"Georg P.","family":"Gyoeri","sequence":"additional","affiliation":[{"name":"Department of Surgery,Division of General Surgery,Medical University of Vienna,General Hospital Vienna,Vienna,Austria"},{"name":"Division of Transplantation,Department of Surgery,Medical University of Vienna,General Hospital Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6700-9163","authenticated-orcid":false,"given":"David","family":"Pereyra","sequence":"additional","affiliation":[{"name":"Department of Surgery,Division of General Surgery,Medical University of Vienna,General Hospital Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Alva\u2010Ruiz","sequence":"additional","affiliation":[{"name":"Department of Surgery,Division of Hepatobiliary and Pancreas Surgery,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Hackl","sequence":"additional","affiliation":[{"name":"Institute of Bioinformatics,Biocenter,Medical University of Innsbruck,Innsbruck,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":false,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Santol","sequence":"additional","affiliation":[{"name":"Department of Surgery,Division of General Surgery,Medical University of Vienna,General Hospital Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Simbrunner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2330-0017","authenticated-orcid":false,"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Berlakovich","sequence":"additional","affiliation":[{"name":"Division of Transplantation,Department of Surgery,Medical University of Vienna,General Hospital Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick S.","family":"Kamath","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Heimbach","sequence":"additional","affiliation":[{"name":"Department of Surgery,Division of Transplantation Surgery,Mayo 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