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Affiliations
Liana Gheorghe
Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest, Romania
Speranta Iacob
Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest, Romania
Razvan Iacob
Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest, Romania
Cristian Gheorghe
Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest, Romania
Irinel Popescu
Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania
How to Cite
Variation of the MELD Score as a Predictor of Death on the Waiting List for Liver Transplantation*
Abstract
Background. Currently, the most recent MELD score available for each waiting list patient is used to prioritize organs.
Aim. The aim of our study was to identify the predictive value for death on a waiting list (WL) for the variation of MELD scores at specific time intervals.
Methods. During 2004-2006, 208 consecutive adult patients were listed for liver transplantation in our Center. To identify the potential predictors of patient death, the univariate and multivariate Coxs proportional hazards regression model was used. To assess the ability of MELD score variation to correctly rank order patients according to risk of death while on the WL, c-statistic was used.
Results. The 12 months actuarial survival was 81%. MELD score variation in the last three months was found as the only independent predictor of death on our WL (p=0.03). The cstatistics for prediction of death on the WL are 0.73 for MELD score at listing, 0.85 for MELD score at last evaluation, 0.62 for MELD variation from inclusion on WL, 0.86 for MELD variation within the last three months.
Conclusion. Dynamic evaluation of MELD scores with its recalculation within the last three months has the best predictive value for death on the WL.