Liver transplant outcome: a comparison between high and low MELD score recipients

Abstract

Objective: To compare low and high MELD scores and investigatewhether existing renal dysfunction has an effect on transplantoutcome. Methods: Data was prospectively collected among 237liver transplants (216 patients) between March 2003 and March2009. Patients with cirrhotic disease submitted to transplantationwere divided into three groups: MELD ≥ 30, MELD < 30, andhepatocellular carcinoma. Renal failure was defined as a ± 25%decline in estimated glomerular filtration rate as observed 1 weekafter the transplant. Median MELD scores were 35, 21, and 13 forgroups MELD ≥ 30, MELD < 30, and hepatocellular carcinoma, respectively. Results: Recipients with MELD ≥ 30 had more daysin Intensive Care Unit, longer hospital stay, and received more bloodproduct transfusions. Moreover, their renal function improved afterliver transplant. All other groups presented with impairment of renalfunction. Mortality was similar in all groups, but renal function wasthe most important variable associated with morbidity and lengthof hospital stay. Conclusion: High MELD score recipients hadan improvement in the glomerular filtration rate after 1 week of livertransplantation.

Keywords

• Liver transplantation
• End stage liver disease
• Severity of illness index
• Renal insufficiency
• Glomerular filtration rate
• Treatment outcome