alexa Evidence-based incorporation of serum sodium concentration into MELD.
Gastroenterology

Gastroenterology

Journal of Liver

Author(s): Biggins SW, Kim WR, Terrault NA, Saab S, Balan V

Abstract Share this page

BACKGROUND & AIMS: Serum sodium (Na) concentrations have been suggested as a useful predictor of mortality in patients with end-stage liver disease awaiting liver transplantation.

METHODS: We evaluated methods to incorporate Na into model for end-stage liver disease (MELD), using a prospective, multicenter database specifically created for validation and refinement of MELD. Adult, primary liver transplant candidates with end-stage liver disease were enrolled.

RESULTS: Complete data were available in 753 patients, in whom the median MELD score was 10.8 and sodium was 137 mEq/L. Low Na (<130 mEq/L) was present in 8% of patients, of whom 90% had ascites. During the study period, 67 patients (9%) died, 243 (32%) underwent transplantation, 73 (10%) were withdrawn, and 370 were still waiting. MELD score and Na, at listing, were significant (both, P < .01) predictors of death within 6 months. After adjustment for MELD score and center, there was a linear increase in the risk of death as Na decreased between 135 and 120 mEq/L. A new score to incorporate Na into MELD was developed: "MELD-Na" = MELD + 1.59 (135 - Na) with maximum and minimum Na of 135 and 120 mEq/L, respectively. In this cohort, "MELD-Na" scores of 20, 30, and 40 were associated with 6%, 16%, and 37% of risk of death within 6 months of listing, respectively. If this new score were used to allocate grafts, it would affect 27% of the transplant recipients.

CONCLUSIONS: We demonstrate an evidence-based method to incorporate Na into MELD, which provides more accurate survival prediction than MELD alone.

This article was published in Gastroenterology and referenced in Journal of Liver

Relevant Expert PPTs

Relevant Speaker PPTs

  • Noelle Mathieu
    Bowel Radiation Injury : Complexity of the Pathophysiology and promise of Cell and Tissue Engineering
    PPT Version | PDF Version
  • Hedef Dhafir El-Yassin
    The Immune Response of Prolactin and the Induction of Tumor Necrosis Factor (TNF) in Iraqi Patients Infected with Hepatitis C Virus
    PPT Version | PDF Version
  • Werner Boecker
    Syringomatous tumour of the nipple and low-grade adenosquamous carcinoma: Evidence for a common origin
    PPT Version | PDF Version
  • Tibor Tot
    Multiparameter characterization of breast carcinoma: subgross, microscopy, proteins, and genes
    PPT Version | PDF Version
  • Fathia El Sharkawi
    The effect of PTEN and TRAIL genes loaded on nanoparticles on hepatocellular carcinoma
    PPT Version | PDF Version
  • Yosef Yarden
    Classically, the 3’untranslated region (3’UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3’UTR alone, without all other elements in mRNA such as 5’UTR and coding region. The importance of independent 3’UTR RNA (referred as I3’UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3’UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3’UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3’UTR were important for its tumor suppression activity. Then, the C/EBP 3’UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3’UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3’UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990’s to 2000’s, world scientists found several 3’UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3’UTR regions, although the existence of their transcribed products as independent 3’UTR RNAs is still to be confirmed. Our studies indicate that the independent 3’UTR RNA is a novel non-coding RNA species whose function should be the regulation not of the expression of their original mRNA, but of some essential life activities of the cell as a whole.
    PPT Version | PDF Version
  • Devathri Nanayakkara
    Context specific role of deubiquitylase enzyme, USP9X in oral squamous cell carcinoma
    PPT Version | PDF Version
  • Giselle L Gotamco
    A case of hybrid carcinoma of the nose
    PDF Version
  • Igor Malyshev
    GENETIC FEATURES OF NO GENERATING SYSTEMS AND RESISTANT TO EHRLICH ASCITES CARCINOMA
    PPT Version | PDF Version
  • Lubna Mushtaque Vohra
    Metaplastic carcinoma of the breast and p16 positivity: What does it mean?
    PPT Version | PDF Version
  • Rubens Mendes Canuto de Oliveira
    Progressive Form Of Biliary And Hepatic Paracoccidioidomycosis, Simulating Cholangiocarcinoma
    PPT Version | PDF Version
  • Myron R Szewczuk
    Transcriptional factor Snail and MMP-9 signaling axis controls tumor neovascularization, growth and metastasis in mouse model of human ovarian carcinoma
    PPT Version | PDF Version
  • Mingsong Wu
    Identification of differentially expressed genes in human lung adenocarcinoma: ERGIC3 as a novel lung cancer-related gene
    PPT Version | PDF Version
  • Flavia Secco Tavares de Souza
    A Comparative Study Among Elective Conventional Surgery, Urgency/Emergency Conventional Approaching and Elective Videolaparoscopic Surgery on the Treatment of Hospitalized Patients at First Surgeric Clinic of Federal Hospital of Bonsucesso with a Diagnostic of Colorectal adenocarcinoma, between January 2010 and December 2012
    PPT Version | PDF Version
  • Ahmed Mohammed Ashshi
    The correlations of activins and follistatin with viral load, liver damage, Interleukin-6 and tumour necrosis factor-α in treatment naïve patients with chronic hepatitis C genotype 1 and 4: A case-control study
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords