The MELD score may help to determine optimum time for liver transplantation
Section snippets
Materials and methods
We retrospectively studied the records of all adult patients who underwent liver transplantation from January 1996 to December 2002. The main indication for liver transplantation was decompensated cirrhosis due to hepatitis B (HBV). All patients had undetectable HBV DNA by Chiron (detection limit 7 × 10/5 copies per mL) at the time of transplantation and were on lamivudine, which was continued posttransplant. Patients who later developed lamivudine resistance were put on adefovir. The
Results
Forty-six adult patients were included in this study with three recipients excluded because of insufficient data to calculate the MELD, one due to retransplantation, and one from recurrence of disseminated HCC. Table 1 shows the patient demographics. There were 11 deaths: sepsis (36%), primary nonfunction (36%), ischemic heart disease with cardiac failure (18%), and hepatic artery thrombosis (9%).
The association between posttransplant survival and pretransplant MELD score was significant at 6
Discussion
We observed that a pretransplant MELD significantly correlated with posttransplant mortality at 6 months but not at 1 year. Clearly pretransplant disease severity has the greatest impact in the early posttransplant period while mortality in the later period is influenced by other factors such as disease recurrence and chronic rejection. Our results suggest that patients with a MELD score less than 32 before transplant show much better survival compared to those with a score of 32 or higher.
Acknowledgments
We would like to thank Christina Yip of National University Hospital for her help.
References (3)
- et al.
A correlation between the pretransplantation MELD score and mortality in the first two years after liver transplantation
Liver Transpl
(2003)
Cited by (2)
Survival tree and meld to predict long term survival in liver transplantation waiting list
2012, Journal of Medical Systems