Factors contributing to gender bias in current MELD scoring and MELD 3.0's correction Kamath and Heimbach, among several other co-authors, on a revised scoring system version correcting the disparity for women introduced by the original MELD score model had been just completed and published and was ready for consideration, so the timing was finally aligned. Kim and Kwong from Stanford with contributions from Drs. When the system finally was revised to address geographic disparity in access to liver transplant with the adoption of a new circle-based organ distribution system in February 2020, an opportunity finally arose to address the long-standing disparity in access to liver transplant experienced by women.
Heimbach indicates that remedying MELD's geographic disparities took longer than national transplant leadership anticipated, lasting approximately eight years. Though Mayo Clinic transplant specialists and others published content about MELD's gender-related disparities, change has been slow, in part because other priorities - such as addressing the complex topic of geographic disparity in access to transplant - took priority, according to Dr. However, beginning in 2008, multiple studies recognized liver transplant selection disparities between male and female patients. The MELD system was not intended to favor men needing liver transplant, and the system's sex-based disparities were not anticipated, says Dr. Kamath, M.D., gastroenterologist at Mayo Clinic's campus in Minnesota, was one of the creators of the MELD scoring system in 2002, originally named the Mayo End-Stage Liver Disease score. Unfortunately, this system has performed less well for female waitlisted candidates, who have experienced 15% lower transplant rate and significantly higher waitlist mortality compared to males. The MELD-based allocation system used since 2002, with a revised version adopted in 2016, has been effective in reducing waitlist mortality overall by prioritizing the most urgent candidates for transplant.
Recognition of MELD's gender bias and movement toward resolution
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