Risk factors and waiting time on the liver transplant list: patients from the Republic of Moldova.


  • Victor PIRVU Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”
  • Angela PELTEC Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”
  • Cristina PIRVU Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”
  • Adrian HOTINEANU Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”




Liver transplantation, Acute on chronic liver failure


Liver transplantation is an important treatment for acute liver failure and end-stage liver disease. In 2002, the model for end-stage liver disease (MELD) was incorporated to prioritize patients awaiting liver transplantation. While there are data on how the MELD score affects wait time, there is a dearth of literature regarding other components. We aimed to evaluate the factors affecting the waiting time for TH. Using the database from the Republic of Moldova, patients aged 18- 65 listed for liver transplants in the period 2013-2022 were included. Variables tested in the model included patient characteristics, biochemical analyses, MELD score, and ABO blood group. The MELD score is used in prioritizing liver allocation and was expected to predict time on the waiting list. Mechanical ventilation and other markers of disease severity are associated with higher MELD scores, thus shorter waiting time. Further research is needed to address the reasons for ariation in waiting time in an attempt to reduce time to TH, standardize the listing process and improve patient outcomes.Objectives. The aim of the scientific paper was to analyze the risk factors and waiting time of patients with liver diseases on the waiting list for liver transplantation. Materials and methods. A retrospective 2013-2018 and prospective 2018-2022 study was conducted, in which 265 patients with decompensated liver cirrhosis, on the waiting list for liver transplantation, were included. The following databases were also used as a source of scientific literature: Google Scholar, PubMed and eLibrary. The keywords that were used in the search: „liver transplant”, „acute and chronic liver failure”. Results. Our results show that those with lower serum sodium had a shorter waiting time compared to candidates with higher sodium. Thus, patients with blood group A were the most patients, which is also a prognosis for this group to be more exposed to the risk of viral infection.

Author Biographies

Victor PIRVU, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”

doctorand, anul IV; Disciplina chirurgie nr.II

Angela PELTEC, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”

dr. în șt. med., conf. univer; Departamentul Medicină Internă, Disciplina de gastroenterologie

Cristina PIRVU, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”

doctorand, anul IV; Departamentul Medicină Internă, Disciplina de gastroenterologie

Adrian HOTINEANU, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”

dr. hab. în șt. med., prof. univer.; Disciplina chirurgie nr.II


Alberino F, Gatta A, Amodio P, et al. Nutrition and survival in patients with liver cirrhosis. Nutrition. 2001;17:445–450.

Bernardi M, Gitto S, Biselli M. The MELD score in patients awaiting liver transplant: strengths and weaknesses. J Hepatol. 2011;54:1297–1306.

Borroni G, Maggi A, Sangiovanni A, Cazzaniga M, Salerno F. Clinical relevance of hyponatraemia for the hospital outcome of cirrhotic patients. Dig Liver Dis. 2000;32:605–610.

Brown RS, Jr, Lake JR. The survival impact of liver transplantation in the MELD era, and the future for organ allocation and distribution. Am J Transplant. 2005;5:203– 204.

Cholongitas E, Burroughs AK. The evolution in the prioritization for liver transplantation. Ann Gastroenterol. 2012;25:6–13.

Freeman RB, Wiesner RH, Edwards E, Harper A, Merion R, Wolfe R, United Network for Organ Sharing Organ Procurement and Transplantation Network Liver and Transplantation Committee Results of the first year of the new liver allocation plan. Liver Transpl. 004;10:7–15.

Gunsar F, Raimondo ML, Jones S, et al. Nutritional status and prognosis in cirrhotic patients. Aliment Pharmacol Ther. 2006;24:563–572.

John S, Thuluvath PJ. Hyponatremia in cirrhosis: pathophysiology and management. World J Gastroenterol. 2015;21:3197–3205.

Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–470.

Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359:1018–1026.

Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31:864–871.

Merion RM, Schaubel DE, Dykstra DM, Freeman RB, Port FK, Wolfe RA. The survival benefit of liver transplantation. Am J Transplant. 2005;5:307–313.

Merli M, Riggio O, Dally L. Does malnutrition affect survival in cirrhosis?PINC (Policentrica Italiana Nutrizione Cirrosi) Hepatology. 1996;23:1041–1046.

Myers RP, Tandon P, Ney M, et al. Validation of the five-variable Model for End-stage Liver Disease (5vMELD) for prediction of mortality on the liver transplant waiting list. Liver Int. 2014;34:1176–1183.

Porcel A, Díaz F, Rendón P, Macías M, Martín-Herrera L, Girón-González JA. Dilutional hyponatremia in patients with cirrhosis and ascites. Arch Intern Med. 2002;162:323–328.

Ruf AE, Kremers WK, Chavez LL, Descalzi VI, Podesta LG, Villamil FG. Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone. Liver Transpl. 2005;11:336–343.

Transplant trends. [[Accessed 6 November 2017]].





Research Article