July 2013

Document Type


Degree Name



Dept. of Public Health and Preventive Medicine


Oregon Health & Science University


Background. Recipients of liver transplantation (LT) for hepatocellular carcinoma (HCC) harbor an 8-20% risk of post-LT HCC recurrence. Studies of ‘downstaging’ HCC outside the Milan criteria suggest that a monitoring period after liver-directed HCC therapy results in comparable post-LT survival to LT of early HCC. I sought to evaluate whether wait list time after MELD prioritization for HCC predicts post-LT survival. Methods. In the UNOS registry, I selected 3 groups registered on the LT wait list from March 2005-March 2008: (1) patients receiving MELD prioritization for HCC, HCC+MP; (2) patients without HCC, NHCC, and (3) patients with HCC who did not receive MELD prioritization, HCC-MP. The primary exposure was the MELD status at LT, a marker of wait list time from initial HCC MELD prioritization to LT. Recipients of LT were followed until death or censoring through October 2012. I compared the association of MELD status at LT with post-LT survival between groups using multiple Co




School of Medicine



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