Pretransplant Model for End-stage Liver Disease Score Has No Impact on Posttransplant Survival in Living Donor Liver Transplantation

Wai, Chun-Tao; Woon, W.-A.; Tan, Ying; Lee, K.-H.; Kc, Tan

doi:10.1016/j.transproceed.2012.01.030

Cited by 10 publications

(3 citation statements)

References 8 publications

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“…The same result was also reported in LDLT [8,9]. However, other studies have concluded that the MELD score had no correlation with graft or patient survival [10][11][12]. We found that a MELD score >20 was associated with a lower one-year survival rate.…”

Section: Discussionsupporting

confidence: 88%

The Impact of Treated Bacterial Infections within One Month before Living Donor Liver Transplantation in Adults

et al. 2014

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Background:The impact of treated preoperative bacterial infections on the outcome of living-donor liver transplantation (LDLT) is not well defined. The aim of this study was to determine the frequency of pre-transplant bacterial infections within one month before LDLT and their impact on the post-transplant morbidity and mortality. Material/Methods:We retrospectively reviewed the records of 50 adult LDLT recipients between January 2009 and October 2011. Patients were divided into two groups based on whether they had episodes of bacterial infections within one month before LDLT. Results:There were 20 patients who required antimicrobial therapy for pre-transplant infections. The pre-transplant infections comprised urinary tract infections (35%), cholangitis (10%), pneumonia (10%), bacteremia (5%), spontaneous bacterial peritonitis (5%), acute sinusitis (5%), subcutaneous abscess (5%), and empirical treatment (25%). Patients with pre-transplant infections had higher Child-Pugh scores [median, 11 vs. 9.5, P<0.05] and model for end-stage liver disease scores [median, 17.5 vs. 14, P<0.05] compared with the other patients. There were no correlations between the pathogens involved in the pre-transplant infections and those involved in post-transplant infections. The incidence of post-transplant infections was higher in the pre-transplant infection group within one week after LDLT, but was almost the same within one month after LDLT. The one-year survival rates were not significantly different between the groups. Conclusions:Although pre-transplant infections are associated with a high risk of postoperative bacterial infection shortly after LDLT, they did not affect the short-term outcome when they had been appropriately treated before transplantation.

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Section: Discussionsupporting

confidence: 88%

The Impact of Treated Bacterial Infections within One Month before Living Donor Liver Transplantation in Adults

et al. 2014

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“…Notably, although the MELD score is widely used as standard tool used to prioritize patients for liver transplantation based on their probability of death, it has several limitations. For instance, there is a debate regarding the correlation between a higher MELD score and a shorter OS [10,[18][19][20][21][22]. Moreover, the majority of HCC patients have underlying cirrhosis and develop serious conditions related to portal hypertension such as refractory ascites, hepatic encephalopathy, hepatorenal syndrome, and variceal bleeding, which are important prognostic factors not inherently taken in consideration by the MELD score despite the fact that they are all critically important in evaluating the severity of liver disease, OS, and determining the need for and timing of OLT [13,44].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the use of exception MELD points has conferred advantage to HCC patients in the liver transplant waiting list, with studies showing decreased waiting list mortality/ dropout when compared to non-HCC candidates [15][16][17]. Therefore, refining OS prediction by MELD score is a priority, especially in the HCC population [18][19][20][21][22][23][24]. An important recent study showed that adding serum sodium (Na + ) level to MELD score improved the MELD score's predictive ability of OS, and previous data suggest the MELD-Na + score improves prognostic ability of the MELD system in patients with HCC [25,26].…”

Section: Introductionmentioning

confidence: 99%

Impact of Integrating Insulin-Like Growth Factor 1 Levels into Model for End-Stage Liver Disease Score for Survival Prediction in Hepatocellular Carcinoma Patients

et al. 2020

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Background: Liver reserve affects survival in hepatocellular carcinoma (HCC). Model for End-Stage Liver Disease (MELD) score is used to predict overall survival (OS) and to prioritize HCC patients on the transplantation waiting list, but more accurate models are needed. We hypothesized that integrating insulin-like growth factor 1 (IGF-1) levels into MELD score (MELD-IGF-1) improves OS prediction as compared to MELD. Methods: We measured plasma IGF-1 levels in training (n = 310) and validation (n = 155) HCC cohorts and created MELD-IGF-1 score. Cox models were used to determine the association of MELD and MELD-IGF-1 with OS. Harrell’s c-index was used to compare the predictive capacity. Results: IGF-1 was significantly associated with OS in both cohorts. Patients with an IGF-1 level of ≤26 ng/mL in the training cohort and in the validation cohorts had significantly higher hazard ratios than patients with the same MELD but IGF-1 >26 ng/mL. In both cohorts, MELD-IGF-1 scores had higher c-indices (0.60 and 0.66) than MELD scores (0.58 and 0.60) (p < 0.001 in both cohorts). Overall, 26% of training and 52.9% of validation cohort patients were reclassified into different risk groups by MELD-IGF-1 (p < 0.001). Conclusions: After independent validation, the MELD-IGF-1 could be used to risk-stratify patients in clinical trials and for priority assignment for patients on liver transplantation waiting list.

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Early post-transplant neopterin associated with one year survival and bacteremia in liver transplant recipients

et al. 2016

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Pretransplant Model for End-stage Liver Disease Score Has No Impact on Posttransplant Survival in Living Donor Liver Transplantation

Cited by 10 publications

References 8 publications

The Impact of Treated Bacterial Infections within One Month before Living Donor Liver Transplantation in Adults

The Impact of Treated Bacterial Infections within One Month before Living Donor Liver Transplantation in Adults

Impact of Integrating Insulin-Like Growth Factor 1 Levels into Model for End-Stage Liver Disease Score for Survival Prediction in Hepatocellular Carcinoma Patients

Early post-transplant neopterin associated with one year survival and bacteremia in liver transplant recipients

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