Characteristics of Waitlisted Patients for Liver Transplantation at a Liver Transplantation Unit in the City of Ribeirão Preto, São Paulo, Brazil, Especially Considering Child and Model for End Stage Liver Disease (MELD) Scores

Abstract

Liver transplantation represents the most effective therapy for patients suffering from chronic end-stage liver disease. Until recently, in Brazil liver allocation was based on the Child-Turcotte-Pugh score and the waiting list followed a chronological criterion. The aim of this study was to show the clinical and laboratory patterns of our patients awaiting a liver transplantation. Seventy-nine medical records were reviewed in January 2005 to classify patients according to their age, sex, cause of cirrhosis, and Child and Model for End Stage Liver Disease (MELD) scores. The mean age of patients was 47 years; 70% were men. The main diagnosis was liver cirrhosis (97%): 27% alcoholic, 26% viral hepatitis, 20% alcoholic plus viral hepatitis, 13% cryptogenic, and 11% other causes. Sixty-three patients (80%) were Child B or C. The average MELD, scores for Child A, B, and C were 10 ± 5, 13 ± 3.4, and 21 ± 4.3, respectively. Nine deaths (11%) on the waiting list occurred in 2005. Among these, 1 patient was Child B with MELD 10, while the others were Child C, with mean MELD scores of 21 ± 3.8. Twelve patients (15%) received cadaveric orthotopic liver transplantation. Thus, in this small series, the higher MELD scores corresponded to Child C class and mortality on the waiting list.