Model for end-stage liver disease score in the first 3 weeks after liver transplantation as a predictor for long-term outcome

Khandoga, Andrej; Iskandarov, Emil; Angele, Martin K.; Gerbes, Alexander L.; Frey, Lorenz; Agayev, B. A.; Jauch, Karl‐Walter; Werner, Jens; Guba, Markus

doi:10.1097/meg.0000000000000505

Cited by 8 publications

(7 citation statements)

References 20 publications

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“…Compared with the original study (12), the preoperative MELD score (21.9 vs. 12), WIT (43.9 vs. 7 min), CIT (492 vs. 424 min) and DRI (1.69 vs. 1.64) indicates that the donor, recipient and operation factors might contribute to the decrease cutoff value of MELDPOD5 (18.9 vs. 18.2) in our study cohort. On the contrary, Khandoga et al (15) in Germany proves that MELDPOD7 >29 had an excellent predictive power of 1-year graft survival, with the preoperative MELD score equal to 24.6 and CIT equal to 564 min. Therefore, the cutoff of 18.2 for MELDPOD5 might be more suitable for the Chinese population.…”

Section: Discussionmentioning

confidence: 90%

Prediction of post-transplant graft survival by different definitions of early allograft dysfunction

Luo¹,

He²,

Chen³

et al. 2021

Ann Palliat Med

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Background: The efficacy of early allograft dysfunction (EAD) definitions in predicting post-transplant graft survival in a Chinese population is still unclear.Methods: A total of 607 orthotopic liver transplants (OLT) have been included in the current study. Model accuracy was evaluated using receiver operating characteristic (ROC) analysis. Risk factors for EAD was evaluated using univariable analysis and multivariable logistic regression model. Results:The 3-, 6-, and 12-month patient/graft survival were 91.6%/91.4%, 91.1%/90%, and 87.5%/87.3%, respectively. MELDPOD5 had a superior discrimination of 3-month graft survival (C statistic, 0.83), compared with MEAF (C statistic, 0.77) and Olthoff criteria (C statistic, 0.72). Multivariate analysis of risk factors for EAD defined by MELDPOD5, showed that donor body mass index (P=0.001), donor risk index (P=0.006), intraoperative use of packed red blood cells (P=0.001), hypertension of recipient (P=0.004), and preoperative total bilirubin (P<0.001) were independent risk factors. Conclusions:The results suggest that MLEDPOD5 is a better criterion of EAD for the Chinese population, which might serve as a surrogate end-point for graft survival in clinical study.

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Section: Discussionmentioning

confidence: 90%

Prediction of post-transplant graft survival by different definitions of early allograft dysfunction

Luo¹,

He²,

Chen³

et al. 2021

Ann Palliat Med

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“…Likewise, another study done by Toshima et al [22] showed that the MELD score on POD2 with an optimal cutoff point of 19 was able to predict mortality and graft loss. Recently, Khandoga et al [23] reported that MELD on POD7 could reliably predict 1-year survival following LT (AUROC c-statistics: 0.73). The findings presented in our study generally support these data, and the predictive power of MELD score on POD5 (AUC: 0.712) could differentiate between survivors and non-survivors within 1 year post LT.…”

Section: Discussionmentioning

confidence: 99%

The utility of early post-liver transplantation model for end-stage liver disease score in prediction of long-term mortality

Dashti

Ebrahimi

Khorasani

et al. 2019

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Background:Little is known about the prognostic ability of post-liver transplantation (LT) model for end-stage liver disease (MELD) score measurement in assessing long-term outcomes. The aim of the present study was to investigate this possible relationship.Methods:In this retrospective cohort study, the medical records of LT recipients operated under a LT program were reviewed. The accuracy of post-operation MELD score for predicting mortality was evaluated based on receiver operating characteristic (ROC) curves. Univariate and Cox proportional hazard regression models were used to assess the risk factors associated with mortality.Results:Eight hundred twenty-six consecutive LT recipients were included in the study. The areas under the ROC curve on postoperative days (POD) 5 and 9 for predicting 1-year mortality were 0.712 (95% confidence interval [CI] 0.614-0.811) and 0.682 (95%CI 0.571-0.798), respectively. A cutoff point of 14.5 was obtained for MELD score on POD5 that significantly differentiated between survivors and non-survivors with a sensitivity of 69.8% (95%CI 50.7-83.1) and a specificity of 57.2% (95%CI 50.6-63.6). In the Cox multivariate analysis, factors including MELD score on POD5 (hazard ratio [HR] 1.83, 95%CI 1.07-3.12; P=0.026), pre-transplant MELD (HR 1.064, 95%CI 1.025-1.104; P=0.001) and operation duration (min) (HR 1.004, 95%CI 1.003-1.006; P=0.013) were identified as independent risk factors for predicting overall survival.Conclusion:The immediate postoperative MELD scores after LT may be of value in predicting mortality and could be used as a tool for postoperative risk assessment of patients.

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“…O escore MELD é amplamente utilizado para predizer o risco de morte de pacientes portadores de doença hepática terminal em um período de três meses, e busca reduzir a mortalidade entre pacientes na fila de espera por transplantes direcionando a alocação dos enxertos (99)(100)(101) . Além disso, investigação recente aponta outra aplicação: predição de uso de unidades de concentrados de hemácias no transoperatório em virtude de sua correlação positiva com o escore MELD (102) .…”

Section: Características Relacionadas àS Infecções Do Sítio Cirúrgicounclassified

Fatores de risco para infecção do sítio cirúrgico em transplante de fígado: coorte histórica

Oliveira¹

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Aos meus pais Fátima e Antônio Carlosde Oliveira (in memoriam), sem vocês não teria chegado até aqui.Ao João Noronha, meu companheiro, pelo apoio e por acreditar nesse sonho. Aos meus irmãos Claucio e Lilian, vocêssão parte de tudo isso, meu exemplo de luta, persistência e carinho. Ao meu sobrinho Pietro, por existir emnossas vidas e torná-las ricas em significado. Aos meus cunhados Roseane Rodrigues e Geraldo Machado, pelo apoio. Aos queridos amigos Maiara e Lucas, pelo carinho. AGRADECIMENTOSA Deus. À Prof.ª Dr.ª Vanessa de Brito Poveda, por me receber no grupo de Pesquisas, mais tarde aceitar me orientar, pelos ensinamentos e por todo o cuidado na condução deste estudo; nos momentos de maior angústia, você foi o apoio necessário para continuar. À Prof.ª Dr.ª Ruth Natália Teresa Turrini, por me receber no grupo de Pesquisas, compor a banca do Exame de Qualificação e pelas importantes contribuições feitas ao longo da realização deste trabalho. À Prof.ª Dr.ª Silvia Regina Secoli e à Prof.ª Dr.ª Érika C. Marocco Duran, por participarem do Exame de Qualificação e pelas valiosas observações feitas ao projeto.À querida amiga que o Mestrado me trouxe, Juliana Chaves Coelho, por muitos momentos de intenso aprendizado compartilhados, por me ouvir nos diversos momentos de angústia e por participar da construção desta pesquisa. À Prof.ª Dr.ª Heloísa Garcia Claro e MSc. Rosana Ribeiro Tarifa, por participarem do primeiro passo para a concretização deste sonho. À Prof.ª Dr.ª Sônia Paiva, pela amizade, pelo respeito e por cuidar da amizade construída desde a Graduação em Poços de Caldas.À querida amiga Ivanyse Pereira (Ivy), pelo exemplo no exercício da Enfermagem, pela convivência enriquecedora e por compartilhar sonhos.Aos membros da banca de defesa, pela disponibilidade e pela valorosa contribuição para esta investigação.Aos pacientes transplantados, ao hospital e equipe médica, por autorizarem o acesso aos prontuários para a elaboração desta investigação.À enfermeira Dalila Faria, à secretária Letícia Araújo e aos colaboradores do Serviço de Arquivo Médico e Estatístico, pela preciosa colaboração na etapa de coleta de dados.

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Model for end-stage liver disease score in the first 3 weeks after liver transplantation as a predictor for long-term outcome

Abstract: In conclusion, early postoperative MELD scores predict outcome after LTX. The postoperative MELD score at POD14 is a good predictor for patient survival and at POD7 for the graft survival after LTX.

Cited by 8 publications

References 20 publications

Prediction of post-transplant graft survival by different definitions of early allograft dysfunction

Prediction of post-transplant graft survival by different definitions of early allograft dysfunction

The utility of early post-liver transplantation model for end-stage liver disease score in prediction of long-term mortality

Fatores de risco para infecção do sítio cirúrgico em transplante de fígado: coorte histórica

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