Delta MELD as a predictor of early outcome in adult-to-adultliving donor liver transplantation


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ACAR Ş., AKYILDIZ M., GÜRAKAR A., TOKAT Y., DAYANGAÇ M.

Turkish Journal of Gastroenterology, vol.31, no.11, pp.782-789, 2020 (SCI-Expanded) identifier identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 11
  • Publication Date: 2020
  • Doi Number: 10.5152/tjg.2020.18761
  • Journal Name: Turkish Journal of Gastroenterology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.782-789
  • Keywords: Living donor liver transplant, MELD change, survival
  • Istanbul Medipol University Affiliated: Yes

Abstract

Background/Aims: An increased post-operative mortality risk has been reported among patients who undergo living donor liver transplantation (LDLT) with higher model for end-stage liver disease (MELD) scores. In this study, we investigated the effect of MELD score reduction on post-operative outcomes in patients with a high MELD (≥20) score by pre-transplant management. Materials and Methods: We retrospectively analyzed 386 LDLT cases, and patients were divided into low-MELD (<20, n=293) vs. highMELD (≥20, n=93) groups according to their MELD score at the time of index hospitalization. Patients in the high-MELD group were managed specifically according to a treatment algorithm in an effort to decrease the MELD score. Patients in the high-MELD group were further divided into 2 subgroups: (1) responders (n=34) to pre-transplant treatment with subsequent reduction of the MELD score by a minimum of 1 point vs. (2) non-responders (n=59), whose MELD score remained unchanged or further increased on the day of LDLT. Responders vs. non-responders were compared according to etiology, demographics, and survival.