J Hepatol: How do I decide who will receive the next liver transplant?

In the United States and Europe, the priority of liver transplantation follows the principle of "the highest priority for the disease".
, however, for patients with hepatocellular carcinoma (liver cancer, HCC), priority is based on binary tumor criteria (e.g., Milan) to speed up transplantation of "acceptable" patients with prognosis for transplantation.
risk scores developed to overcome the limitations of these binary standards (e.g., Metroticket, HALT-HCC) are not sufficient for waiting for prioritization because they focus only on HCC-related pre-porting factors.
, David and others tried to use HCC-related and non-HCC-related variables to develop risk scores to predict post-transplant survival in HCC patients.
a retrospective queue study using national registration data from patients receiving liver transplants (DDLT) from deceased recipients between 27 February 2002 and 31 December 2018.
Cox regression model analysis focused on 5- and 10-year survival rates, using manual variable selection to estimate the β coefficient of the risk score, calculating the absolute predicted survival time, and comparing it with the existing risk score.
the probability of survival after transplantation in patients with different scores was 11 variables in 6,502 adult liver cancer patients who had liver transplants.
0.62 (95% CI 0.57 to 0.67) and 0.65 (95% CI 0.58 to 0.72), respectively, with no statistical difference compared to Metroticket and HALT-HCC ratings.
LITES-HCC scores were able to distinguish patients based on post-transplant survival rates in patients who met Milan and UCSF.
, David and others have developed and validated a risk scoring method that predicts survival after transplantation in patients with liver cancer.
By incorporating HCC-related and non-HCC-related variables (e.g., age, chronic kidney disease), this scoring method allows transplant professionals to prioritize liver cancer patients to be transplanted based on the predicted post-transplant survival rate, which can be used to determine who can receive transplants first.
: In the case of a shortage of transplanted organs, this method can indeed bring some benefits.
But according to who is the most likely to survive the transplant to decide who receives liver transplant, this practice is very European and American, as in the new crown outbreak, Europe and the United States do not give patients over 60 years of age to use a ventilator ...