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The MELD score may help to determine optimum time for liver transplantation
Authors:Lee Y M  Fernandes M  Da Costa M  Lee K H  Sutedja D  Tai B C  Tan K C  Isaac J  Prabhakaran K  Lim S G
Institution:Department of Medicine, National University Hospital, Singapore. mdcleeym@nus.edu.sg
Abstract:BACKGROUND: The model for end-stage liver disease (MELD) score is a good predictor of mortality on the waiting list and short-term survival post liver transplantation. Aim: Our aim was to determine if there is a pretransplant MELD score beyond which liver transplantation is prohibitive. PATIENTS AND METHODS: Forty-six adult patients underwent primary liver transplantation from January 1996 to December 2002. Patients followed to the most recent visit or death underwent survival analysis using Cox regression and Kaplan Meier methods. RESULTS: There was a significant correlation between the pretransplant MELD score and survival at 6 months posttransplant (P=.037 95% CI: 1.004-1.13). Patients with pretransplant MELD score greater than or equal to 32 showed significantly greater mortality compared with those less than 32 (HR 9.18, 95%CI=1.16-72.44). CONCLUSION: Pretransplant MELD may help to determine the optimum time for liver transplantation.
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