Supporting Table 1: Activity of liver transplantation in France in
2005-2009, national data from the “Agence de la Biomédecine”
2005
2006
2007
2008
2009
2010
Patients still awaiting on 01/01
449
474
486
539
668
806
New registrants/year
1219
1299
1346
1371
1465
1579
Died on waiting list
63
123
116
107
135
169
Removed from waiting list
120
86
135
158
146
192
Transplantations, deceased donor
975
1001
1043
1001
1035
1092
Transplantations, living donor
49
36
18
10
12
17
22.2
23.2
24.7
24.6
23.2
22.8
Rate of organ donation per million
population
Supporting Table 2: Standardized forms for each MELD exception
Refractory Ascites
Transplant team:
Physician name:
Date:
Patient :
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Cause of liver disease:
HCC : yes/no
Diuretic failure: yes/no
Reason for stopping diuretics: inefficacy/ hyponatremia / renal failure
Number of paracentesis per month:
Removed volume: /paracentesis
Hydrothorax with hypoxemia requiring repeated thoracocenteses: yes/no, nb/month :
Natremia :
mmol/L
Spontaneous bacterial peritonitis: yes/no
TIPSS: no/patent/obstructed/contra indicated (encephalopathy: yes/no, if yes:
acute/chronic/grade:
, portal vein thrombosis)
Denutrition : no/moderate/severe
Chronic Encephalopathy
Transplant team:
Physician name:
Date:
Patient :
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Cause of liver disease:
HCC : yes/no
Number of admissions in ICU for encephalopathy within the last 6 months :
Need of mechanical ventilation: yes/no
Number of in-hospital admission for encephalopathy within the last 6 months:
Porto-systemic shunts on imaging: yes/no
Surgical porto-systemic derivation or TIPSS: yes/no
Focal encephalopathy: yes/no
Recurrent gastrointestinal bleeding
Transplant team:
Physician name:
Date:
Patient:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Cause of liver disease:
HCC : yes/no
Cause of bleeding: oesophageal varices/gastric varices/ectopic varices/gastric antral
vascular ectasia
Number of admissions in ICU for digestive bleeding within the last 6 months:
Patient admitted in ICU at time of MELD exception request: yes/no
Haemodynamic instability: yes/no
Vasoactive drugs: yes/no
TIPSS: no/patent/obstructed/ contra indicated
Surgical porto-systemic shunt: yes/no
Hepatopulmonary syndrome
Transplant team:
Physician name:
Date:
Patient:
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Cause of liver disease:
HCC : yes/no
Room air PaO2 (mm Hg):
Oxygen therapy: yes/no
Normal chest imaging: yes/no
Positive contrast-enhanced echocardiography: yes/no
Quantification of intrapulmonary shunt with lung perfusion scintigraphy :
%
Portopulmonary hypertension
Transplant team:
Physician name:
Date:
Patient :
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Cause of liver disease:
HCC: yes/no
Right heart catheterization (before treatment)
-
Mean pulmonary arterial pressure (mm Hg):
-
pulmonary capillary wedge pressure (mm Hg):
-
Pulmonary arterial resistances (dynes.s.cm-5):
-
Cardiac index (L/min/1,73 m2):
Medical treatment: prostacyclin / prostaglandin agonists / phosphodiesterase type 5
inhibitors
Right heart catheterization under treatment
-
Mean pulmonary arterial pressure (mm Hg):
-
pulmonary capillary wedge pressure (mm Hg):
-
Pulmonary arterial resistances (dynes.s.cm-5):
-
Cardiac index (L/min/1,73 m2):
Refractory pruritus
Transplant team:
Physician name:
Date:
Patient :
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Cause of liver disease:
HCC: yes/no
Malnutrition: no/moderate/severe
Sleep disorders: yes/no
Medical therapy: ursodesoxycholic acid/cholestyramine/rifampicin/naltrexone/sertralin
Albumin dialysis: yes/no
Recurrent bacterial cholangitis
Transplant team:
Physician name:
Date:
Patient:
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Cause of liver disease:
HCC: yes/no
Drainage: no /endoscopic/percutaneous
Number of episodes of bacteriemia within the last 6 months:
Number of episodes of severe infections within the last 6 months:
Number of sequentiel antibiotherapy within the last 6 months :
In patient candidate for retransplantation
Episode of septic shock: yes/no
Infection(s) with multiresistant agents: yes/no
Hereditary haemorrhagic telangiectasia
Transplant team:
Physician name:
Date:
Patient :
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
1) High-output cardiac failure
-
increased left ventricular filling pressure on transthoracic Doppler
echocardiography: yes/no
-
Right heart catheterization
o PCWP (mmHg):
o Diastolic pulmonary arterial pressure (mm Hg):
or
2) Biliary manifestations
- diffuse cholangitis: yes/no
- angiocholitis: yes/no
- liver abscess: yes/no
Polycystic liver disease
Transplant team:
Physician name:
Date:
Patient :
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Surgical resection contra-indicated: yes/no
Nutritional status: good/ moderate/ poor
Serum albumin (g/L):
Muscle wasting: no/moderate/severe
Ascites: yes/no
Combined kidney transplantation: yes/no
Familial amyloidosis polyneuropathy
Transplant team:
Physician name:
Date:
Patient :
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Isolated sensory polyneuropathy: yes/no
Motor polyneuropathy
o Walk with stick: yes/no
o Walk impossible: yes/no
Dysautonomic symptoms
o Digestive disturbances: yes/no
o Myocardic features: yes/no
o Urinary and genital dysfunction: yes/no
Denutrition: no/moderate/severe
Hilar cholangiocarcinoma
Transplant team:
Physician name:
Date:
Patient:
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Primitive sclerosing cholangitis : yes/no
CA 19-9 value:
Histologic confirmation: yes/no
Neoadjuvant treatment
o External beam radiotherapy: yes/no
o Chemotherapy: yes/no
Staging laparotomy with systematic lymph node picking: yes/no
o Residual tumor: yes/no
Hepatic metastases in gastro-intestinal
endocrine tumors
Transplant team:
Physician name:
Date:
Patient :
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Localization of primitive tumor: small bowel/pancreas/other :
/unknown
Primitive tumor resected: yes/no
Secretant tumor : yes/no
MIB-index:
%
Bilobar localization of hepatic metastases: yes/no
Symptomatic hepatomegaly: yes/no
Stabilization of liver lesions with adjuvant therapies within the last 6 months: yes/no
Hepatic epitheloid hemangio-endothelioma
Transplant team:
Physician name:
Date:
Patient:
Sex:
Age:
Weight:
Height:
Blood group:
PI*(%):
INR:
Serum bilirubin
(µmol/L):
Creatinine
(µmol/L) :
MELD:
*PI: prothrombin index
Large unresectable tumor: yes/no
Extra hepatic metastases: lung/bone/spleen/peritoneum
Tumor progression within the last 3 months: yes/no