CORRELATION OF PRE-TRANSPLANT MELD SCORE WITH 30 AND 60 DAYS’ MORTALITY IN PATIENTS OF LIVER TRANSPLANT
DOI:
https://doi.org/10.55519/JAMC-03-13246Abstract
Background: The Model for End-Stage Liver Disease (MELD) score, introduced in 2002 by the United Network for Organ Sharing (UNOS), is a vital tool for predicting mortality for liver transplant candidates. Comprising serum creatinine, serum bilirubin, and international normalized ratio (INR), the MELD score includes kidney, liver, and coagulation pathway function, providing a comprehensive prognostic tool. Recent studies suggest broader prognostic implications, extending beyond organ allocation. Despite its benefits, around 15%-20% of patients may not experience accurate survival predictions. Methods: This retrospective single-center study, covering January 2016 to September 2023 with 87 patients, explores the correlation between pre-transplant MELD scores and 30 to 60-day post-transplant survival. Results: Our analysis reveals no significant impact of MELD scores on survival during this period, challenging existing literature (p=0.068). The study underscores the need for nuanced risk assessment beyond MELD scores, considering diverse clinical scenarios and patient-specific variables. Conclusion: Our findings contribute to refining predictive models and advocate for larger-scale investigations, emphasizing a holistic approach to optimize liver transplantation outcomes.References
Onaca NN, Levy MF, Sanchez EQ, Chinnakotla S, Fasola CG, Thomas MJ, et al. A correlation between the pretransplantation MELD score and mortality in the first two years after liver transplantation. Liver Transpl 2003;9(2):117–23.
Kamath P, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001;33(2):464–70.
Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology 2003;124(1):91–6.
Roth JA, Chrobak C, Schädelin S, Hug BL. MELD score as a predictor of mortality, length of hospital stay, and disease burden: A single-center retrospective study in 39,323 inpatients. Medicine 2017;96(24):e7155.
Kim MS, Kato TS, Farr M, Wu C, Givens RC, Collado E, et al. Hepatic Dysfunction in Ambulatory Patients With Heart Failure. J Am Coll Cardiol 2013;61(22):2253–61.
Biegus J, Zymliński R, Sokolski M, Siwołowski P, Gajewski P, Nawrocka‐Millward S, et al. Impaired hepato‐renal function defined by the MELD XI score as prognosticator in acute heart failure. Eur J Heart Fail 2016;18(12):1518–21.
Sivayoham N, Rhodes A, Cecconi M. The MISSED score, a new scoring system to predict Mortality In Severe Sepsis in the Emergency Department: a derivation and validation study. Eur J Emerg Med 2014;21(1):30–6.
Said A. Model for end stage liver disease score predicts mortality across a broad spectrum of liver disease. J Hepatol 2004;40(6):897–903.
Fischer CM, Yano K, Aird WC, Shapiro NI. Abnormal Coagulation Tests Obtained in the Emergency Department are Associated with Mortality in Patients with Suspected Infection. J Emerg Med 2012;42(2):127–32.
Sern Lim H. Baseline MELD-XI score and outcome from veno-arterial extracorporeal membrane oxygenation support for acute decompensated heart failure. Eur Heart J Acute Cardiovasc Care 2016;5(7):82–8.
Kamath PS, Kim WR. The model for end-stage liver disease (MELD). Hepatology 2007;45(3):797–805.
Moraes ACO, Oliveira PC, Fonseca-Neto OCLD. The impact of the meld score on liver transplant allocation and results: an integrative review. Arq Bras Cir Dig 2017;30(1):65–8.
Morales-Arráez D, Ventura-Cots M, Altamirano J, Abraldes JG, Cruz-Lemini M, Thursz MR, et al. The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study. Am J Gastroenterol 2022;117(2):301–10.
Mehmood T, Zia M, Latif A, Ansar S. Mortality Related Factors in Patients with Variceal Bleeding with MELD Score ≥18. J Coll Physicians Surg Pak 2019;29(12):1199–202.
Diaz Soto JC, Mauermann WJ, Lahr BD, Schaff H V, Luis SA, Smith MM. MELD and MELD XI Scores as Predictors of Mortality After Pericardiectomy for Constrictive Pericarditis. Mayo Clin Proc 2021;96(3):619–35.
Samuel D, Coilly A. Management of patients with liver diseases on the waiting list for transplantation: a major impact to the success of liver transplantation. BMC Med 2018;16(1):113.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Faryal Riaz Khan Khan, Rao Saad Ali Khan, Khawar Shabbir, Asim Shehzad, Fuad Ahmad Siddiqi, Zara Riaz Khan, Salahuddin
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.