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6% versus 3.4% for a MELD score of 21-23, P < 0.001; 11.4% versus 5.9% for a MELD score of 24-26, P < 0.001; and 15.6% versus 8.0% for a MELD score of 27-29, P < 0.001). There was regional variability in the 90-day rates of waitlist removal for death or clinical deterioration among the HCC and non-HCC cohorts (Supporting Fig. 1). The variability was similar among the HCC cohorts with MELD scores of 22 and 25, but it was much more pronounced among the non-HCC cohorts. Among the HCC candidates who were removed for death or clinical deterioration, the mean laboratory MELD score at removal was 22.4 �� 10.2, and the scores were similar across all 3 MELD categories. However, among the non-HCC candidates, the MELD score at removal increased from 29.2 �� 7.7 for the cohort with MELD scores of 21 to 23 to 31.9 �� 9.0 for the cohort with MELD scores of 24 to 26 and to 32.2 �� #keep##links# 6.5 for the cohort with MELD scores of 27 to 29. Among the HCC candidates removed for death or clinical deterioration, the laboratory MELD score at removal was higher than the exception MELD score for 106 of the 259 candidates (40.9%) with a MELD score of 22, for 22 of the 93 #keep##links# candidates (23.7%) with a MELD score of 25, and for 5 of the 20 candidates (25.0%) with a MELD score of 28. Among the HCC and non-HCC waitlist candidates in each MELD stratum who were removed for clinical deterioration, similar proportions subsequently died during follow-up. However, in each MELD stratum, HCC candidates survived longer after delisting than non-HCC candidates (Table 2). The median survival times were as follows: 27 days (interquartile range = 3-187 days) for patients with a MELD score of 22 versus 2 days (interquartile range = 1-14 days) for patients with a MELD score of 21 to 23 (P < 0.001), 87 days (interquartile range = 8-202 days) for patients with a MELD score of 25 versus 3 days (interquartile range = 1-13 days) for patients with a MELD score of 24 to 26 (P < 0.001), and 32.5 days (interquartile range = 1-175 days) for patients with a MELD score of 28 versus 1 day (interquartile range = 0-6 days) for patients with a MELD score of 27 #keep##links# to 29 (P = 0.02). To explore whether the risk of waitlist dropout for HCC candidates varied according to the initial listing laboratory MELD scores, we stratified HCC candidates into 2 groups: laboratory MELD scores �� 15 and laboratory MELD scores < 15.14 Candidates with a laboratory MELD score �� 15 at the initial listing had a higher 90-day risk of removal for death or clinical deterioration (8.4% versus 2.5% for the cohort with a MELD score of 22, P < 0.001; 7.8% versus 3.6% for the cohort with a MELD score of 25, P < 0.001; and 5.2% versus 2.3% for the cohort with a MELD score of 28, P = 0.06).
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