{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T07:35:36Z","timestamp":1769844936986,"version":"3.49.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T00:00:00Z","timestamp":1372636800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2013,6,25]],"date-time":"2013-06-25T00:00:00Z","timestamp":1372118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>In July 2005, Argentina became the first country after the United States to introduce the Model for End-Stage Liver Disease (MELD) for organ allocation. In this study, we investigated waiting-list (WL) outcomes (n = 3272) and post\u2013liver transplantation (LT) survival in 2 consecutive periods of 5 years before and after the implementation of a MELD-based allocation policy. Data were obtained from the database of the national institute for organ allocation in Argentina. After the adoption of the MELD system, there were significant reductions in WL mortality [28.5% versus 21.9%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001, hazard ratio (HR) = 1.57, 95% confidence interval (CI) = 1.37-1.81] and total dropout rates (38.6% versus 29.1%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001, HR = 1.31, 95% CI = 1.16-1.48) despite significantly less LT accessibility (57.4% versus 50.7%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001, HR = 1.53, 95% CI = 1.39-1.68). The annual number of deaths per 1000 patient-years at risk decreased from 273 in 2005 to 173 in 2010, and the number of LT procedures per 1000 patient-years at risk decreased from 564 to 422. MELD and Model for End-Stage Liver Disease\u2013Sodium scores were excellent predictors of 3-month WL mortality with c statistics of 0.828 and 0.857, respectively (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). No difference was observed in 1-year posttransplant survival between the 2 periods (81.1% versus 81.3%). Although patients with a MELD score &gt; 30 had lower posttransplant survival, the global accuracy of the score for predicting outcomes was poor, as indicated by a c statistic of only 0.523. Patients with granted MELD exceptions (158 for hepatocellular carcinoma and 52 for other reasons) had significantly higher access to LT (80.4%) in comparison with nonexception patients with equivalent listing priority (MELD score = 18-25; 54.6%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001, HR = 0.49, 95% CI = 0.40-0.61). In conclusion, the adoption of the MELD model in Argentina has resulted in improved liver organ allocation without compromising posttransplant survival. <jats:italic toggle=\"yes\">Liver Transpl 19:711\u2013720, 2013.<\/jats:italic>. \u00a9 2013 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.23665","type":"journal-article","created":{"date-parts":[[2013,6,15]],"date-time":"2013-06-15T07:42:48Z","timestamp":1371282168000},"page":"711-720","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":34,"title":["Improved Waiting-List Outcomes in Argentina After the Adoption of a Model for End-Stage Liver Disease\u2013Based Liver Allocation Policy"],"prefix":"10.1097","volume":"19","author":[{"given":"Nora Gabriela","family":"Cejas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico G.","family":"Villamil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier C.","family":"Lendoire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviana","family":"Tagliafichi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Lopez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela Hansen","family":"Krogh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos A.","family":"Soratti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liliana","family":"Bisigniano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R3-4-20250124","doi-asserted-by":"crossref","first-page":"693699","DOI":"10.1056\/NEJM199603143341104","article-title":"Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis.","volume":"334","author":"Mazzaferro","year":"1996","journal-title":"N Engl J Med"},{"key":"R4-4-20250124","doi-asserted-by":"crossref","first-page":"567580","DOI":"10.1053\/jlts.2001.25879","article-title":"MELD and PELD: application of survival models to liver allocation.","volume":"7","author":"Wiesner","year":"2001","journal-title":"Liver 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