Response to "Reply to: 'The decreasing predictive power of MELD in an era of changing etiology of liver disease'"

We appreciate Kwong et al.'s utilization of Harrell's c-statistic and its ability to incorporate follow-up time as a valuable contribution to the discussion about our group's findings.1 We acknowledge that the conventional area under receiver-operating-characteristic curve concordance statistic has limitations; however, we selected the conventional c-statistic to remain methodologically consistent with the manner in which the Model for End-Stage Liver Disease (MELD) was originally designed and validated, first to predict post-TIPS survival, then when applied to ESLD generally, and finally when integrated into allocation.