The Model for End-Stage Liver Disease (MELD) score the criteria for allocation in liver transplantation for patients with chronic disease.
This score is effective in predicting mortality in patients awaiting liver transplantation, however, its abilities to predict post-transplantation outcome are not clear.
In this study, researchers from Dallas, Texas, compared outcomes in the first 2 years after liver transplantation, according to the pre-transplantation MELD score.
The research team assessed 669 consecutive patients who underwent primary liver transplantation between 1993 and 1999, in a single transplant center.
The team excluded patients who died of malignancy.
They calculated the pre-transplantation MELD scores using the United Network for Organ Sharing formula.
|Post-transplantation survival at 3, 6, 12, 18, and 24 months, was lower in groups with a higher MELD score.|
The researchers then stratified patients according to MELD score (<15, 15 to 24, and ≥25).
The research team found that post-transplantation survival at 3, 6, 12, 18, and 24 months, was significantly lower in the groups with a higher MELD score.
This difference was significant for hepatitis C and noncholestatic liver diseases, but not cholestatic diseases.
Furthermore, in patients with a MELD score between 15 and 24, survival was significantly greater with cholestatic diseases, and lower in patients with hepatitis C.
Dr Nicholas Onaca's team concluded, "In our study, pretransplantation MELD score correlates with survival in the first 2 years after transplantation".
"There is a survival advantage for patients with cholestatic diseases compared with those with hepatitis C".
"These findings suggest the need to readjust MELD score-based allocation decisions to consider patient outcome".