A high MELD score, combined with the presence of hepatitis C, is associated with a poor prognosis in living donor liver transplantation.

Abstract

PURPOSE:

The feasibility of performing living donor liver transplantation (LDLT) for patients with high end-stage liver disease (MELD) scores needs to be assessed.

METHODS:

A total of 357 patients who underwent LDLT were included in this analysis.

RESULTS:

Overall, 46 patients had high MELD scores (≥ 25) and their graft survival was similar to that in patients with low MELD scores (<25; n = 311; p = 0.395). However, among patients with high MELD scores, a multivariate analysis showed that the presence of hepatitis C (p = 0.013) and LDLT in Era-I (p = 0.036) was significantly associated with a poorer prognosis. Among patients with hepatitis C (n = 155), the 5-year graft survival rate was significantly lower in patients with high MELD scores (33.7 %, p < 0.001) than in patients with low MELD scores. The 5-year graft survival rate was significantly lower in patients in Era-I (n = 119) compared with those in Era-II/III when stratified by low (73.0 vs. 82.5 %, p = 0.040) and high (55.0 vs. 86.1 %, p = 0.023) MELD scores. Among the patients with high MELD scores, those with hepatitis C and LDLT in Era-I had the worst 5-year graft survival rate (14.3, p < 0.001).

CONCLUSION:

The graft outcomes in patients with high MELD scores and the presence of hepatitis C were found to be particularly poor.

• Authors: Toru Ikegami, Ken Shirabe, Shohei Yoshiya, Tomoharu Yoshizumi, Yo-Ichi Yamashita, Norifumi Harimoto, Takeo Toshima, Hideaki Uchiyama, Yuji Soejima, Yoshihiko Maehara
• Journal: Surgery today (Surg Today) Vol. 44 Issue 2 Pg. 233-40 (Feb 2014) ISSN: 1436-2813 [Electronic] Japan
• PMID: 23435837 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• End Stage Liver Disease (complications, diagnosis, surgery)
• Feasibility Studies
• Female
• Follow-Up Studies
• Graft Survival
• Hepatitis C (complications)
• Humans
• Liver Transplantation
• Living Donors
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Time Factors
• Treatment Outcome