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Impact of dynamic changes in MELD score on survival after liver transplantation – a Eurotransplant registry analysis
Author(s) -
Györi Georg P.,
Silberhumer Gerd R.,
Rahmel Axel,
Vries Erwin,
Soliman Thomas,
Zehetmayer Sonja,
Rogiers Xavier,
Berlakovich Gabriela A.
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13075
Subject(s) - liver transplantation , medicine , transplantation , liver disease , waiting list , survival analysis , retrospective cohort study , model for end stage liver disease , surgery , intensive care medicine
Background & Aims With restricted numbers of available organs, futility in liver transplantation has to be avoided. The concept of dynamic changes in MELD score (Delta MELD ) has previously been shown to be a simple tool to identify patients with the greatest risk of death after transplantation. Aim was to validate this concept with the Eurotransplant ( ET ) database. Methods A retrospective registry analysis was performed on all patients listed for liver transplantation within ET between 2006 and 2011. Patients <18 years of age, acute liver failure, malignancy and patients listed for retransplantation were excluded. Influence of MELD at listing ( MELD on), MELD at transplantation ( MELD off), Delta MELD , age, sex, underlying disease and time on the waiting list on overall survival after liver transplantation were evaluated. Results A total of 16 821 patients were listed for liver transplantation, 8096 met the inclusion criteria. Age, MELD on and Delta MELD showed significant influence on survival on the waiting list. Age and Delta MELD showed influence on survival after liver transplantation, with Delta MELD >10 showing a 1.6‐fold increased risk of death. Conclusion The concept of Delta MELD was validated in a large, prospective data set. It provides a simple tool to identify patients with increased risk of death after liver transplantation and might help improve long‐term results.