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(D+10) MELD as a novel predictor of patient and graft survival after adult to adult living donor liver transplantation
Author(s) -
Soin Arvinder Singh,
Goja Sanjay,
Yadav Sanjay Kumar,
Tamang Tseten Yonjen,
Rastogi Amit,
Bhangui Prashant,
Thiagrajan Srinivasan,
Raut Vikram,
Babu Raghvendra Y.,
Saigal Sanjiv,
Saraf Neeraj,
Choudhary Narendra Singh,
Vohara Vijay
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12939
Subject(s) - medicine , living donor liver transplantation , liver transplantation , transplantation , surgery , survival analysis , population , gastroenterology , propensity score matching , environmental health
We modified the previously described D‐MELD score in deceased donor liver transplant, to (D+10)MELD to account for living donors being about 10 years younger than deceased donors, and tested it on living donor liver transplantation (LDLT) recipients. Five hundred consecutive LDLT, between July 2010 and December 2012, were retrospectively analyzed to see the effect of (D+10)MELD on patient and graft survival. Donor age alone did not influence survival. Recipients were divided into six classes based on the (D+10)MELD score: Class 1 (0‐399), Class 2 (400‐799), Class 3 (800‐1199), Class 4 (1200‐1599), Class 5 (1600‐1999), and Class 6 (>2000). The 1 year patient survival (97.1, 88.8, 87.6, 76.9, and 75% across Class 1‐5, P =.03) and graft survival (97.1, 87.9, 82.3, 76.9, and 75%; P =.04) was significantly different among the classes. The study population was divided into two groups at (D+10)MELD cut off at 860. Group 1 had a significantly better 1 year patient (90.4% vs 83.4%; P =.02) and graft survival (88.6% vs 80.2%; P =.01). While donor age alone does not predict recipient outcome, (D+10)MELD score is a strong predictor of recipient and graft survival, and may help in better recipient/donor selection and matching in LDLT.