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Predicting short-term survival after liver transplantation on eight score systems: a national report from China Liver Transplant Registry

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ABSTRACT

To compare the performance of eight score systems (MELD, uMELD, MELD-Na. iMELD, UKELD, MELD-AS, CTP, and mCTP) in predicting the post-transplant mortality, we analyzed the data of 6,014 adult cirrhotic patients who underwent liver transplantation between January 2003 and December 2010 from the China Liver Transplant Registry database. In hepatitis B virus (HBV) group, MELD, uMELD and MELD-AS showed good predictive accuracies at 3-month mortality after liver transplantation; by comparison with other five models, MELD presented the best ability in predicting 3-month, 6-month and 1-year mortality, showing a significantly better predictive ability than UKELD and iMELD. In hepatitis C virus and Alcohol groups, the predictive ability did not differ significantly between MELD and other models. Patient survivals in different MELD categories were of statistically significant difference. Among patients with MELD score >35, a new prognostic model based on serum creatinine, need for hemodialysis and moderate ascites could identify the sickest one. In conclusion, MELD is superior to other score systems in predicting short-term post-transplant survival in patients with HBV-related liver disease. Among patients with MELD score >35, a new prognostic model can identify the sickest patients who should be excluded from waiting list to prevent wasteful transplantation.

No MeSH data available.


Distribution of MELD scores in cirrhotic patients undergoing liver transplantation: (A) all study patients; (B) patients survived at 3-month post-transplantation; (C) patients died within 3-month post-transplantation.
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f1: Distribution of MELD scores in cirrhotic patients undergoing liver transplantation: (A) all study patients; (B) patients survived at 3-month post-transplantation; (C) patients died within 3-month post-transplantation.

Mentions: The distribution of MELD scores among all study patients were presented in Fig. 1A with a mean value of 20.8 ± 8.7. Mean MELD scores of patients died within 3 months after transplantation versus survivors were 25.3 ± 8.9 and 20.2 ± 8.4 (P < 0.001), respectively (Fig. 1B and C).


Predicting short-term survival after liver transplantation on eight score systems: a national report from China Liver Transplant Registry
Distribution of MELD scores in cirrhotic patients undergoing liver transplantation: (A) all study patients; (B) patients survived at 3-month post-transplantation; (C) patients died within 3-month post-transplantation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
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getmorefigures.php?uid=PMC5304182&req=5

f1: Distribution of MELD scores in cirrhotic patients undergoing liver transplantation: (A) all study patients; (B) patients survived at 3-month post-transplantation; (C) patients died within 3-month post-transplantation.
Mentions: The distribution of MELD scores among all study patients were presented in Fig. 1A with a mean value of 20.8 ± 8.7. Mean MELD scores of patients died within 3 months after transplantation versus survivors were 25.3 ± 8.9 and 20.2 ± 8.4 (P < 0.001), respectively (Fig. 1B and C).

View Article: PubMed Central - PubMed

ABSTRACT

To compare the performance of eight score systems (MELD, uMELD, MELD-Na. iMELD, UKELD, MELD-AS, CTP, and mCTP) in predicting the post-transplant mortality, we analyzed the data of 6,014 adult cirrhotic patients who underwent liver transplantation between January 2003 and December 2010 from the China Liver Transplant Registry database. In hepatitis B virus (HBV) group, MELD, uMELD and MELD-AS showed good predictive accuracies at 3-month mortality after liver transplantation; by comparison with other five models, MELD presented the best ability in predicting 3-month, 6-month and 1-year mortality, showing a significantly better predictive ability than UKELD and iMELD. In hepatitis C virus and Alcohol groups, the predictive ability did not differ significantly between MELD and other models. Patient survivals in different MELD categories were of statistically significant difference. Among patients with MELD score &gt;35, a new prognostic model based on serum creatinine, need for hemodialysis and moderate ascites could identify the sickest one. In conclusion, MELD is superior to other score systems in predicting short-term post-transplant survival in patients with HBV-related liver disease. Among patients with MELD score &gt;35, a new prognostic model can identify the sickest patients who should be excluded from waiting list to prevent wasteful transplantation.

No MeSH data available.