{"doi":"10.1002/hep.32770","title":"Mortality in patients with end‐stage liver disease above model for end‐stage liver disease 3.0 of 40","abstract":"<jats:sec>\n            <jats:title>Background and Aims:</jats:title>\n            <jats:p>Since the implementation of the model for end‐stage liver disease (MELD) score to determine waitlist priority for liver transplant (LT) in 2002, the score has been capped at 40. Recently, the MELD 3.0 score was proposed to improve upon MELD‐Na. Here, we examine waitlist mortality and LT outcomes in patients with MELD 3.0 ≥ 40 to assess the potential impact of uncapping the score.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results:</jats:title>\n            <jats:p>Adult waitlist registrations for LT from January 2016 to December 2021 were identified in the registry data from the Organ Procurement and Transplant Network. All MELD 3.0 scores were calculated at registration and thereafter. Waitlist mortality for up to 30 days was calculated as well as post‐LT survival. There were 54,060 new waitlist registrations during the study period, of whom 2820 (5.2%) had MELD 3.0 ≥ 40 at listing. The 30‐day waitlist mortality was high in these patients, yet it increased further in proportion with MELD 3.0 up to a score of 55 with 30‐day mortality of 58.3% for MELD 3.0 of 40–44 and 82.4% for ≥50. The multivariable hazard ratio was 1.13 for each point of MELD 3.0, adjusting for several variables including acute‐on‐chronic liver failure. The number of LT recipients with MELD 40 at transplant increased from 155 in 2002 to 752 in 2021. Posttransplant survival was comparable across MELD strata including MELD of 35–39.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:</jats:title>\n            <jats:p>MELD 3.0 scores beyond 40 are associated with increasing waitlist mortality without adversely affecting posttransplant outcome. Uncapping the MELD score in waitlist candidates may lead to greater survival benefit from LT.</jats:p>\n          </jats:sec>","journal":"Hepatology","year":2023,"id":26529,"datarank":1.1474435429205114,"base_score":2.833213344056216,"endowment":2.833213344056216,"self_citation_contribution":0.42498200160843247,"citation_network_contribution":0.722461541312079,"self_endowment_contribution":0.42498200160843247,"citer_contribution":0.722461541312079,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":15,"citers_with_citation_signal":10,"citers_with_endowment":10,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":153281,"name":"Ajitha Mannalithara","orcid":null,"position":1,"is_corresponding":false},{"id":153282,"name":"Paul Y. Kwo","orcid":"0000-0002-8234-4485","position":2,"is_corresponding":false},{"id":153283,"name":"C. Andrew Bonham","orcid":null,"position":3,"is_corresponding":false},{"id":153284,"name":"Allison Kwong","orcid":"0000-0002-3874-6612","position":4,"is_corresponding":false},{"id":153280,"name":"W. Ray Kim","orcid":"0000-0002-3030-860X","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"base_score":2.833213344056216,"endowment":2.833213344056216,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36052665","pmcid":"PMC10556544","openalex_id":"https://openalex.org/W4294225803","authors":[],"funders":[{"funder_name":"NIAAA NIH HHS","grant_id":"K23 AA029197","title":null},{"funder_name":"National Institute of Diabetes and Digestive and Kidney Diseases","grant_id":"T32DK007056","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"R01 DK127224","title":null},{"funder_name":"Health Resources and Services Administration","grant_id":"HHSH250‐2019‐00001C","title":null}],"total_grants":4,"fwci":1.747,"citation_percentile":0.84988607,"influential_citations":1,"citation_trend":[{"year":2023,"count":6},{"year":2024,"count":4},{"year":2025,"count":3},{"year":2026,"count":3}],"oa_status":"green","license":"http://doi.wiley.com/10.1002/tdm_license_1.1","oa_locations":[{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10556544/pdf/nihms-1835670.pdf","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556544","host_type":"GREEN"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10556544/pdf/nihms-1835670.pdf","host_type":"repository"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1002/hep.32770","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1002/hep.32770","host_type":"publisher"},{"url":"https://journals.lww.com/10.1002/hep.32770","host_type":"publisher"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10556544","host_type":"repository"},{"url":"https://doi.org/10.1002/hep.32770","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/36052665","host_type":"repository"}],"fields_of_study":["Liver Disease and Transplantation","Organ Transplantation Techniques and Outcomes","Liver Diseases and Immunity","Medicine","Adult","Humans","End Stage Liver Disease","Severity of Illness Index","Liver Transplantation","Tissue and Organ Procurement","Proportional Hazards Models","Waiting Lists"],"mesh_terms":["Adult","Humans","Tissue and Organ Procurement","Severity of Illness Index","Waiting Lists","Proportional Hazards Models","Liver Transplantation","End Stage Liver Disease"],"keywords":["Medicine","Model for End-Stage Liver Disease","Liver disease","United Network for Organ Sharing","Internal medicine","Hazard ratio","Liver transplantation","Gastroenterology","Surgery","Transplantation","Confidence interval"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-06-08T14:46:46.764980Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}