Potential predictive value of the MELD score for short-term mortality after liver transplantation.
In the last years, a model for end-stage liver disease (MELD) was suggested as a disease severity score for patients with end-stage liver disease awaiting liver transplantation. In the early 2002, United Network for Organ Sharing (UNOS) has proposed to replace the current status 2A, 2B, and 3 by a modified version of the original MELD score based upon patient risk for 3-month mortality on the waiting list. In this study UNOS status and MELD score were evaluated retrospectively for postoperative 3-month mortality in patients who underwent liver transplantation from 2000 to 2001. Liver recipients were stratified for UNOS status 2A, 2B, and 3, and the corresponding MELD score was calculated for each patient. A receiver operating characteristic (ROC) analysis was performed for both conventional UNOS status and MELD score by fitting patient deaths within 3 months after liver transplantation. The MELD score revealed a better prediction rate for 3-month mortality after the first LT than conventional UNOS status, although no statistical significance was evident by ROC curve comparison. This preliminary study seems to suggest a potentially better predictive rate for the MELD score than conventional UNOS status concerning short-term mortality after liver transplantation.
Santori
G
G
Department of Transplantation, San Martino University Hospital, Genoa, Italy. gsantori@medscape.com
Andorno
E
E
Antonucci
A
A
Morelli
N
N
Bottino
G
G
Mondello
R
R
Valente
R
R
Panaro
F
F
Ravazzoni
F
F
Di Domenico
S
S
Savelli
A
A
Valente
U
U
D006801:Humans; D017093:Liver Failure / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D011237:Predictive Value of Tests; D012372:ROC Curve; D016019:Survival Analysis; D013997:Time Factors