Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Severity of liver disease not a reliable indicator of quality of life

24.01.2005


A new study on the determination of how livers are allocated for transplants examined the relationship between liver disease severity and quality of life, and found that the commonly used model for liver allocation is not a reliable indicator of general quality of life.



The results of this study appear in the February 2005 issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS). The journal is published on behalf of the societies by John Wiley & Sons, Inc.

Liver allocation is currently based on a patient’s score on the Model for End-Stage Liver Disease (MELD), which uses results of three laboratory tests to predict short-term prognoses of liver disease. Because the MELD score is based on clinical findings, it is believed to be an accurate measure of liver disease severity. However, complications such as hepatic encephalopathy (which involves brain damage, personality changes, and intellectual impairment) and ascites (an accumulation of excess fluid in the abdomen), are not accounted for in the MELD score. MELD is now used in place of the Child-Turcotte-Pugh (CTP) model, which does take into account these complications and therefore is thought to be associated with quality of life.


Led by Sammy Saab, M.D., M.P.H., of the David Geffen School of Medicine at UCLA, the study included 150 adult patients awaiting their first liver transplant at the University of California Los Angeles between July 2003 and May 2004. Liver disease severity was assessed using both the CTP classification and the MELD score. In addition, patients completed two self-administered health-related quality of life questionnaires: the Medical Outcomes Short Form 36 (SF-36) and the Chronic Liver Disease Questionnaire. The results showed that while quality of life is impaired in patients with end-stage liver disease, there is a poor correlation between quality of life scores and the severity of disease as measured by MELD.

"Patients consider quality of life in addition to survival when making healthcare decisions," note the authors. "In liver disease in particular, it is essential to understand the impact of their disease on their quality of life because of the prolonged wait for transplantation." They suggest that liver disease severity should not be assumed to be an accurate marker for quality of life and that future studies in patients awaiting liver transplants should include quality of life measures as well as survival.

An accompanying editorial by Richard B. Freeman, M.D. of the Division of Transplant Surgery at Tufts-New England Medical Center in Boston, MA, notes that while quality of life is an important component of healthcare decision-making, decisions about organ allocation must be considered within the context of the severe organ shortage. "In the current extremely constrained donor supply, the question is not whether an individual patient’s HRQL [health-related quality of life] is poor enough to warrant intervention with transplantation but more directly, to whom, among all of the potential recipients of a given donor liver, should that donor liver be offered." He maintains that quality of life should not outweigh mortality risk in organ allocation decisions and that a patient must first be alive in order to measure his or her quality of life.

David Greenberg | EurekAlert!
Further information:
http://www.interscience.wiley.com/journal/livertransplantion
http://www.wiley.com

More articles from Studies and Analyses:

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Attoseconds break into atomic interior

A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.

In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...

Im Focus: Good vibrations feel the force

A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.

By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...

Im Focus: Developing reliable quantum computers

International research team makes important step on the path to solving certification problems

Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Basque researchers turn light upside down

23.02.2018 | Physics and Astronomy

Finnish research group discovers a new immune system regulator

23.02.2018 | Health and Medicine

Attoseconds break into atomic interior

23.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>