ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Inactive Status Change is an Independent Predictor of Waitlist Mortality and Disproportionately Impacts Patients in Donor Service Areas with a Higher Median MELD at Transplant

R. Batra1, S. Noreen2, D. Stewart3, D. Haakinson1, G. Gan3, Y. Deng3, S. Kulkarni1

1Surgery, Yale University School of Medicine, New Haven, CT, 2UNOS, Richmond, VA, 3Yale University, New Haven, CT

Meeting: 2020 American Transplant Congress

Abstract number: C-250

Keywords: Allocation, Donation, Liver, Liver transplantation

Session Information

Session Name: Poster Session C: Non-Organ Specific: Public Policy & Allocation

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Liver waitlist mortality is calculated by including both active and inactive patients. As inactive patients are unable to receive organ offers, models that adjust for activity status may improve accuracy of waitlist outcomes. For patients listed active, the quantitative impact of an inactive status change on waitlist mortality is unknown, as are the differences between the different donor service areas (DSA).

*Methods: We constructed a multistate model using the OPTN database (06/18/2013 to 06/08/2018) to calculate the probability of the following competing risks: deceased donor transplant, living donor transplant, waitlist removal due to death or other/well. MELD exception patients including Status-1 were excluded. We grouped DSA’s by their Median Meld at Transplant (MMaT) and separated them into tertiles (low, medium, high MMaT DSA). Following an active listing, we measured the probability of death with or without an inactive status change at 90 days from listing. This is an adjusted model.Note: the probabilities are predicted for a 56 years old non-Hispanic white male, with blood type O and private insurance (Figure)

*Results: There were 25,216 patients of which 24,838 (98.5%) were listed as active. The most common reason for an inactive status change was temporarily too sick, which was used most often in the low MMaT DSA category (low MMaT (61.7%); medium MMaT (57.2%); high MMaT (52.3%). Other common reasons, incomplete work-up (11.2%) and insurance issues (11.2%) were not appreciably different across DSA tertiles. Dynamic prediction modelling shows that an inactive status change at 90 days is associated with higher mortality across all listing MELD and DSA categories. The probability of death did not differ among MMaT DSA categories for patients with initial MELD>35, but an inactive status change resulted in significantly higher mortality in the MELD 15-25 and 26-34 groups in the highest MMaT DSA tertile (figure).

*Conclusions: An inactive status change markedly increases liver transplant waitlist mortality. The probability of death after an inactive status change is much larger in DSA’s where the MMaT is the highest.

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Batra R, Noreen S, Stewart D, Haakinson D, Gan G, Deng Y, Kulkarni S. Inactive Status Change is an Independent Predictor of Waitlist Mortality and Disproportionately Impacts Patients in Donor Service Areas with a Higher Median MELD at Transplant [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/inactive-status-change-is-an-independent-predictor-of-waitlist-mortality-and-disproportionately-impacts-patients-in-donor-service-areas-with-a-higher-median-meld-at-transplant/. Accessed May 10, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences