Model for End-stage Liver Disease (MELD) as a Predictor of Post-Transplant Survival

Abstract

Introduction: Model for end-stage liver disease (MELD) score had been showed to reliably predict orthotopic liver transplant waitlist mortality. Previous studies of MELD and post-transplant outcomes have had conflicting results. We investigated the correlation between the MELD score at the time of liver transplant with subsequent survival at our institution. Methods: Patients who underwent orthotopic liver transplant at MedStar Georgetown University Hospital between 2000 and 2014 were included in the study. The correlation between the Model for end-stage liver disease (MELD) score at the time of liver transplantation with subsequent survival was calculated at intervals of 1 week, 1 month, 6 months, and 1 year. The Mann-Whitney U test was performed to detect differences between the survival group and non-survival group. A P-value of < 0.05 is considered significant. Results: A total of 790 cases underwent liver transplantation. A majority of patients had hepatitis C. Lower MELD scores at the time of liver transplant listing significantly correlated with survival at 1 month (21.66 vs. 26.99 p < 0.01), 6 months (21.58 vs. 24.44 p < 0.01) and 1 year (21.58 vs. 23.95 p 0.01) (see table). Conclusion: This study shows that the MELD score is an important tool in predicting post-liver transplant survival in patient's at our center.Table 1: MELD score as predictor of survival