Background: Once patients with cirrhosis experience decompensation, early mortality risk increases sharply. Liver transplantation (LT) is currently the definitive treatment for decompensated liver diseases. The model for end-stage liver disease (MELD) score is especially useful for prioritizing candidates for transplantation. However, several categories of MELD were developed and the ability of preoperative different MELD scores to predict short-term postoperative outcome require more assessment.
Objective: The aim of this study was to evaluate the predictive ability of six different types of MELD score for short-term morbidity and mortality after living donor liver transplantation (LDLT).
Methods: During the 5-year of this retrospective study from August 2007 to December 2012. Preoperative standard MELD and other types of MELD score (MELD-Na, MESO index, United Kingdom MELD (UK MELD), integrated MELD (I MELD) equation and the updated MELD) were calculated for each one of the consecutively admitted 50 patients at Al-Sahel Teaching Hospital for living donor liver transplantation (LDLT). Standard MELD score were categorized into low ≤ 15 points in, moderate from16 to 25 points and high ˃25 points.
Results: Morbidity in the form of graft rejection 10%, infection 14%, biliary complications 28%, vascular complications 14%, renal 26% others e.g. (drug toxicity, haematemesis, liver tear, hepatic abscess, HCC recurrence, and melena) had occurred in 20% and mortality in 12% within 6 months. Preoperative standard MELD and other types of MELD scores including MELD- Na, UK MELD, MESO, Updated MELD and I MELD had no significant difference in prediction of patients with and without complications. In addition, mortality had no significant difference between standard MELD and other studied types of MELD after six months of follow up (P value ˃ 0.05). Preoperative standard MELD score were low in 14 patients, moderate in 29 patients and high in 7 patients with also, no statistically significant difference between each category as regarding postoperative morbidity and mortality within six months after LDLT (P value ˃ 0.05).
Conclusion: This study concluded that there is no difference between preoperative standard MELD and other types including MELD-Na, UK MELD, MESO, Updated MELD and I MELD in prediction of short-term morbidity and mortality after LDTL and even preoperative standard MELD scores (mild, moderate and high) have no role in prediction of short-term outcomes (morbidity and mortality). However, standard MELD remain the most reliable and applicable method in preoperative prioritizing of patients waiting for LDTL.
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