Starlinger P, Ahn JC, Mullan A, et al. - Improvement in the prediction of mortality among patients with cirrhosis on the liver transplant (LT) waiting list was achieved by adding von Willebrand factor antigen (vWF-Ag) and C-reactive protein (CRP)—reflecting central pathophysiological mechanisms of PH, bacterial translocation, and inflammation, that are all drivers of mortality on the waiting list—to the Model for End-Stage Liver Disease-Sodium (MELD-Na) score.

• Researchers suggest the utility of the vWFAg-CRP-MELD-Na model for prioritizing organ allocation for improving prediction of waitlist mortality and lowering waitlist mortality.

• Two independent cohorts (Medical University of Vienna [exploration cohort] and Mayo Clinic Rochester [validation cohort]) were assessed for CRP and vWF-Ag at LT listing.

• In the exploration cohort (n = 269), improvement in the predictive value of MELD-Na for 3-month waitlist mortality was observed with both vWF-Ag and CRP and the highest predictive value was observed when these were used in combination.

• In an independent validation cohort (n = 129), the results were confirmed.

• An independent association of vWF-Ag was observed with PH and inflammatory biomarkers, whereas CRP showed close, and MELD had independent links with biomarkers of bacterial translocation/inflammation.