Glossary entry

French term or phrase:

une composante expert

English translation:

extra liver allocation exception points, assigned through expert review

Added to glossary by Charles Ferguson
Oct 27, 2015 12:54
8 yrs ago
7 viewers *
French term

une composante expert

French to English Medical Medical (general) Patient being considered for a second liver transplant
This patient's case has been presented at a meeting of transplant surgeons. The patient has had many complications, the most important of which are liver abscesses and he has been repeatedly re-admitted to hospital for fever. The meeting "a conclu à une indication de retransplantation avec UNE COMPOSANTE EXPERT (my caps)". Could this be an expert opinion, or an expert surgeon, or something else? Thanks for any clarification!

Proposed translations

+1
22 hrs
Selected

extra liver allocation exception points, assigned through expert review

Hi Sean, I've suggested a gloss, because it's a feature of France's own liver allocation system. My understanding is that priority for a liver graft is given to patients with a high score in a scoring system specific to France (although basically similar to scores used elsewhere). But when a doctor considers there are good reasons to bump a patient up on the waiting list because their condition is more dire than their score suggests, they can apply for extra points to be awarded through independent expert review. These points are the composante expert. A similar but not identical system exists in the US, where the transplant doctor applies to the Regional Review Board for a MELD exception.

http://www.academie-medecine.fr/wp-content/uploads/2014/09/t... contains an explanation of what composante expert means:
"Indications rares et exceptions au score MELD : la composante expert (...) Dans ces situations, l’équipe ayant en charge le patient doit formuler une demande circonstanciée d’évaluation du dossier par un collège indépendant d’experts nommés par l’Agence de la Biomédecine. Un binôme de 2 experts analyse le dossier et propose après accord un nombre de points prédéterminé à octroyer au candidat en un délai donné, en fonction de la situation clinique. Ainsi, pour une ascite réfractaire, l’obtention de 650 points en 6 mois est proposée. Ce système permet ainsi au candidat desservi par le score MELD d’obtenir une compensation et un accès équitable à la TH. En cas de désaccord entre deux experts, un troisième expert peut être sollicité.
Le taux d’acceptation d’une composante expert est voisin de 65 %."

This explanation from the Agence de la Biomédecine specifically mentions repeat transplantation:
"Demande d’attribution d’une composante expert dans le calcul du score Foie
Cette composante a été créée pour les malades ayant des particularités cliniques comme certaines hépatopathies non cirrhotiques (amylose, polykystose, maladie de Rendu Osler,…) ou des retransplantations avec dégradation de l’état clinique, et pour lesquelles la composante « hépatopathies métaboliques » ou « retransplantations » n’octroie pas suffisamment de points pour accéder à la greffe dans le temps imparti par la gravité de leur maladie."
http://www.agence-biomedecine.fr/IMG/pdf/v25guide-regles-de-...

These 2 articles discuss the French system in English and compare it with the US system:
http://onlinelibrary.wiley.com/doi/10.1002/lt.22363/full
http://onlinelibrary.wiley.com/doi/10.1002/lt.22402/pdf
Note from asker:
Thank you, Helen for this comprehensive explanation of the French points scheme. Something similar possibly exists in Northern Ireland but I am not familiar with the transplant teams here.
Peer comment(s):

agree Michael Lotz
3 hrs
Thanks Michael :-)
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4 KudoZ points awarded for this answer. Comment: "You sure went the extra mile here. Mille fois merci!"
3 hrs

expert advice or consensus

Expert consensus on the scheme of pathological diagnosis ...
www.thecco.net/article/view/960/1242
Traduire cette page
de WM Cong - ‎2012 - ‎Autres articles
Expert consensus on the scheme of pathological diagnosis of primary liver cancer. ... Pathological Group of Hepatobiliary Tumors and Liver Transplantation.
Peer comment(s):

neutral Anne Schulz : Do you have any evidence that "composante expert" is used in that sense? // Then the information about personal experience with "componsante expert" may be more interesting to the asker than a ref. showing that "expert consensus" exists in English ;-)
4 hrs
Yes I do, I work with the ID unit in a teaching hospital.
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17 hrs
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