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Hazard ratios for the occurrence http://www.selleckchem.com/products/gsk1120212-jtp-74057.html of an SBE award were estimated accounting for these competing risks, with patients censored according to the first event that occurred during their course. Multivariable competing risk regression, based on the proportional subdistribution method, was conducted with adjustments for the primary covariate of interest, UNOS region and for the simultaneous effects of the following patient characteristics: MELD score, registration year, encephalopathy severity, ascites severity, functional status, liver disease diagnosis, blood group, age, ethnicity, insurer, education level, gender and foreign birth (24). The statistical significance of the adjusted effects of each covariate was assessed at the p http://www.selleck.cn/products/pd-1-pd-l1-inhibitor-2.html regression models (4.2% of patients were missing data). No data imputation was performed in the final model given the low prevalence of missing data. Table 2 lists the descriptive characteristics of the study population. 39 169 listed candidates had complete datasets since the inception of MELD through November 22, 2006. Of the five possible first-events, 14 325 underwent transplantation, 7845 candidates died or removed from the list due to severity of illness and 10 561 candidates continued on the waiting and had no censoring event. There were a total of 6438 first-event MELD exceptions: 4705 were HCC-related, 391 were standard exceptions and 1342 were SBEs. Across all regions, 3.4% of the study population received SBE exception awards. The region-specific percent ranged from 1.5% to 6.2%. Table 3 displays the mean physiologic MELD score at the time of registration and at transplantation in each region over the study period. Regions 1 (22.1 �� 9.5), 5 (23.7 �� 11.2), 7 (21.3 �� 9.6), and 9 (20.9 �� 10.4) had the highest mean physiologic MELD scores at transplantation. The mean overall approval rate for all types of MELD exception was 74%. SBE approval rates ranged between 33% and 65% with a median http://www.selleckchem.com/products/MDV3100.html acceptance rate of 53%. A total of 1342 candidates had a SBE as their first-event. Of those patients, 935 underwent transplantation (69%), while 407 did not. Of the 407 candidates who did not undergo transplantation, 228 (56%) suffered waiting list death or removal due to illness (17% of all candidates with first-event of SBE). Table 4 shows the rates for denial of SBE requests by region as well as the eventual outcomes of the patients who did not receive a SBE despite a request. A total of 48% of SBE requests were denied nationwide.