Therapeutic evaluation of the patients with high MELD scores undergoing liver transplantation for benign end-stage liver disease

Abstract

Objective To analyze the impact of a model for end-stage liver disease(MELD)score≥30 on one-year survival after orthotopic liver transplantation(OLT).Methods The data of 80 cases of benign end-stage liver diseases undergoing liver transplantation from Jaa 2004 to Jaa 2008 were retrospectively analyzed.MELD scores were examined before OLT,and the patients were divided into two groups according to their MELD scores:group 1,MELD≥30(n=23),and group 2,MELD ＜30(n=57).Operative time,anhepatic phase,intraoperative blood products transfusion,intensive care unit(ICU)stay,and one-year survival were compared between two groups.Results The operative time and ICU were prolonged,and intraoperative blood products transfusion was increased significantly in group 1 as compared with those in group 2(P＜0.05),but there was no significant difference in anhepatic phase and one-year survival between two groups.There was significant difference in serum sodium,serious hepatic encephalopathy and ventilation before OLT between deaths and survivors(P＜0.05)Conclusion In patients with end-stage liver diseases,serum sodium,serious hepatic encephalopathy and ventilation before liver transplantation may have prognostic values in addition to the MELD score for prediction of mortality in patients with high MELD scores. Key words: Liver transplantation; Model,end-stage liver disease; Liver diseases; Prognosis