Sluggish decline in a post-transplant model for end-stage liver disease score is a predictor of mortality in living donor liver transplantation

Won Jung Hwang, Joon Pyo Jeon, Seung Hee Kang, Hyun Sik Chung, Ji Yong Kim, Chul Soo Park

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: The pre-transplant model for end-stage liver disease (pre-MELD) score is controversial regarding its ability to predict patient mortality after liver transplantation (LT). Prominent changes in physical conditions through the surgery may require a post-transplant indicator for better mortality prediction. We aimed to investigate whether the post-transplant MELD (post-MELD) score can be a predictor of 1-year mortality. Methods: Perioperative variables of 269 patients with living donor LT were retrospectively investigated on their association with 1-year mortality. Post-MELD scores until the 30th day and their respective declines from the 1st day post-MELD score were included along with pre-MELD, acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment (SOFA) scores on the 1st post-transplant day. The predictive model of mortality was established by multivariate Cox's proportional hazards regression. Results: The 1-year mortality rate was 17% (n = 44), and the leading cause of death was graft failure. Among prognostic indicators, only post-MELD scores after the 5th day and declines in post-MELD scores until the 5th and 30th day were associated with mortality in univariate analyses (P < 0.05). After multivariate analyses, declines in post-MELD scores until the 5th day of less than 5 points (hazard ratio 2.35, P = 0.007) and prolonged mechanical ventilation ≥24 hours were the earliest independent predictors of 1-year mortality. Conclusions: A sluggish decline in post-MELD scores during the early post-transplant period may be a meaningful prognostic indicator of 1-year mortality after LT.

Original languageEnglish
Pages (from-to)160-166
Number of pages7
JournalKorean Journal of Anesthesiology
Volume59
Issue number3
DOIs
StatePublished - Sep 2010

Keywords

  • Liver transplantation
  • Living donor
  • Mortality
  • Prediction

Fingerprint

Dive into the research topics of 'Sluggish decline in a post-transplant model for end-stage liver disease score is a predictor of mortality in living donor liver transplantation'. Together they form a unique fingerprint.

Cite this