Risk-benefit point of the Model for End-stage Liver Disease score in patients waiting for deceased-donor liver transplantation: A single-center experience.

Abstract

To clarify the risk-benefit point of the Model for End-stage Liver Disease (MELD) score in patients waiting for deceased-donor liver transplantation (DDLT). The present study retrospectively investigated 213 patients registered on the waiting list at Kyoto University (Kyoto, Japan) between 2005 and 2016. Patients were stratified by MELD score (6-9/10-14/15-20/21-30/31-40) and classified into two groups: the DDLT group (30 patients) and the waiting group (183 patients). Their post-registration mortality risk and long-term survival were compared. For all MELD categories, the mortality risk was lower in the DDLT group than in the waiting group. The hazard ratio of post-registration mortality decreased in the DDLT group compared to the waiting group as the MELD score increased (0.36/0.12/0.06/0.042/0.004). Survival was significantly better among patients in the DDLT group with a MELD score of 15 or more than among patients in the waiting group. For all MELD categories, DDLT reduced the mortality risk of patients on the waiting list.