Impact of the MELD score on waiting time and disease severity in liver transplantation in United States veterans

Ahmad, Jawad; Downey, Kathy K.; Akoad, Mohamed; Cacciarelli, Thomas V.

doi:10.1002/lt.21262

Cited by 44 publications

(36 citation statements)

References 19 publications

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“…The MELD scoring system has been widely applied in recent years and shown to predict mortality across a broad spectrum of liver diseases in most studies [11][12][13][14] . MELD has been demonstrated to have a better ability in short-term or intermediate-term outcome prediction in comparison with the Child-Turcotte-Pugh (CTP) system [15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

Evolution of systemic therapy of advanced hepatocellular carcinoma

Jiang

Liu²,

Xiong³

et al. 2008

WJG

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year, the iMELD still had the highest AUC (0.783), the difference between the iMELD and MELD was statistically significant (P < 0.05). Survival curves showed that the three new models were all clearly discriminated the patients who survived or died in short-term as well as intermediate-term (P < 0.001 INTRODUCTIONThe model for end-stage liver disease (MELD) was developed as a prognostic model of short-term mortality in patients with cirrhosis treated with transjugular intrahepatic portosystemic shunt (TIPS) [1] . The scoring system has been widely applied in recent years and shown to predict mortality across a broad spectrum of liver diseases in most studies. But, there is not any parameter correlated with complications of cirrhosis in this formula. Its ability of prognosis is decreased. Some studies have indicated that serum sodium is the independent predictor of mortality in patients with cirrhosis [2,3] . And the incorporation of Na into the MELD may enhance its prognostic accuracy [4,5] . Then some scholars had successively introduced three new mathematical equations based on both MELD and Na, Abstract AIM: To investigate the prognostic value of the model for end-stage liver disease (MELD) and three new MELD-based models combination with serum sodium in decompensated cirrhosis patients-the MELD with the incorporation of serum sodium (MELD-Na), the integrated MELD (iMELD), and the MELD to sodium (MESO) index. METHODS: A total of 166 patients with decompensated cirrhosis were enrolled into the study. MELD, MELDNa, iMELD and MESO scores were calculated for each patient following the original formula on the first day of admission. All patients were followed up at least 1 year. The predictive prognosis related with the four models was determined by the area under the receiver operating characteristic curve (AUC) of the four parameters. Kaplan-Meier survival curves were made using the cut-offs identified by means of receiver operating characteristic (ROC). RESULTS: Out of 166 patients, 38 patients with significantly higher MELD-Na (28.84 ± 2.43 vs 14.72 ± 0.60), iMELD (49.04 ± 1.72 vs 35.52 ± 0.67), MESO scores (1.59 ± 0.82 vs 0.99 ± 0.42) compared to the survivors died within 3 mo (P < 0.001). Of 166 patients, 75 with markedly higher MELD-Na (23.01 ± 1.51 vs 13.78 ± 0.69), iMELD (44.06 ± 1.19 vs 34.12 ± 0.69), MESO scores (1.37 ± 0.70 vs 0.93 ± 0.40) than the survivors died within 1 year (P < 0.001). At 3 mo of enrollment, the iMELD had the highest AUC (0.841), and was followed by the MELD-Na (0.766), MESO (0.723), all larger than MELD (0.773); At 1

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Section: Discussionmentioning

confidence: 99%

Evolution of systemic therapy of advanced hepatocellular carcinoma

Jiang

Liu²,

Xiong³

et al. 2008

WJG

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“…All patients were positive for hepatitis C antigen for anti-HCV antibody and HCV RNA RT-PCR. The severity of liver disease was calculated according to the model for end stage liver disease (18). Patients with the past or current hepatocellular carcinoma, NAFLD, NASH, alcoholic, diabetes, cardiovascular disease, and kidney disease, or any other viral infection, hepatitis delta, or hepatitis B virus were excluded from the present study.…”

Section: Patients and Collection Of Serum Samplesmentioning

confidence: 99%

Serum Metabolic Profiling of Advanced Cirrhosis Based on HCV

et al. 2017

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Background: Cirrhosis is recognized by a reduction in hepatocyte proliferation with an increase in fibrous tissue, which may ultimately lead to the development of cancerous nodules. Liver biopsy has remained the gold standard for confirming liver fibrosis stages, but there are not any nonreversible and specific therapeutic targets in advanced cirrhosis. In the present study, we used the NMR method to find potential therapeutic markers in serum of HCV -cirrhotic patients with advanced stage.Methods: A metabolic profiling study was conducted using 2 groups: decompensated HCV-cirrhosis patients (n = 21) and healthy controls (n = 18). 1H nuclear magnetic resonance (NMR) approach was used to obtain the serum metabolic profiles of the samples. The acquired data were processed by the multivariate principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Moreover, metabolic pathways were determined using MetaboAnalyst 3.0.Results: Specifically, 16 metabolites showed alteration between the 2 groups. Compared with healthy controls, a number of metabolites showed increased concentration in serum of decompensated HCV-cirrhosis such as succinic acid, isovaleraldehyde, citrulline, propanal and cinnamaldehyde, while several others were observed in decreased levels in the decompensated HCV-cirrhosis such as valine, glutamine, trimethylamine, lactate, proline, aspartate, lipid, VLDL, isoleucine, fucose, and glutamate. Aminoacyl-tRNA biosynthesis, alanine, aspartate, glutamate metabolism and arginine, and proline metabolism are the most significant pathways associated with advanced HCV-cirrhosis. Conclusions:Metabolomic profiling through NMR can identify the metabolic disturbances in advanced HCV-cirrhosis. Aberrant amino acid biosynthesis may be the hallmark with increasing severity of cirrhosis as well as alterations in energetic metabolism.

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“…Decompensated cirrhosis was defined as the presence of at least two of the following five criteria: ascites, hyperbilirubinemia, peripheral edema of noncardiac or renal origin, hypoalbuminemia and an INR (clotting times, as reflected by the international normalized ratio) > 1.3 [8] . The severity of liver disease was calculated according to the model for end-stage liver disease [9] .…”

Section: Clinical Criteriamentioning

confidence: 99%

¹H NMR-based serum metabolic profiling in compensated and decompensated cirrhosis

Qi¹

2012

WJG

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AIM:To study the metabolic profiling of serum samples from compensated and decompensated cirrhosis patients. METHODS:A pilot metabolic profiling study was con ducted using three groups: compensated cirrhosis patients (n = 30), decompensated cirrhosis patients (n = 30) and healthy controls (n = 30). A 1 H nuclear magnetic resonance (NMR)-based metabonomics approach was used to obtain the serum metabolic profiles of the samples. The acquired data were processed by multivariate principal component analysis and orthogonal partial least-squares discriminant analysis (OPLS-DA). RESULTS:The OPLS-DA model was capable of distinguishing between decompensated and compensated CONCLUSION:1 H NMR spectra combined with pattern recognition analysis techniques offer a new way to diagnose compensated and decompensated cirrhosis in the future.

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Impact of the MELD score on waiting time and disease severity in liver transplantation in United States veterans

Cited by 44 publications

References 19 publications

Evolution of systemic therapy of advanced hepatocellular carcinoma

Evolution of systemic therapy of advanced hepatocellular carcinoma

Serum Metabolic Profiling of Advanced Cirrhosis Based on HCV

¹H NMR-based serum metabolic profiling in compensated and decompensated cirrhosis

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Impact of the MELD score on waiting time and disease severity in liver transplantation in United States veterans

Cited by 44 publications

References 19 publications

Evolution of systemic therapy of advanced hepatocellular carcinoma

Evolution of systemic therapy of advanced hepatocellular carcinoma

Serum Metabolic Profiling of Advanced Cirrhosis Based on HCV

1H NMR-based serum metabolic profiling in compensated and decompensated cirrhosis

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Product

Resources

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¹H NMR-based serum metabolic profiling in compensated and decompensated cirrhosis