title: MELD fails to measure quality of life in liver transplant candidates.
abstract: Previous studies have demonstrated an association between Child Turcotte-Pugh (CTP) class and impaired quality of life. However, the relationship between the model for end-stage liver disease (MELD) score and quality of life (QOL) has not been well studied. In this study, quality of life questionnaires (Medical Outcomes Short Form 36 [SF-36] and the Chronic Liver Disease Questionnaire [CLDQ]) were administered to 150 adult patients awaiting liver transplantation. We also collected demographic data and laboratory results and recorded manifestations of hepatic decompensation. The study found that all domains of the SF-36 and CLDQ were significantly lower in our patient cohort than in normal controls (P < .001). There was a moderate negative correlation between CPT class and physical components of the SF-36 (r = -.30), while there was a weak negative correlation (r = -.10) between CPT class and the mental component. There was a negative moderate correlation between CPT class and overall CLDQ (r = -.39, P < .001) and a weak correlation (r = -.20) between MELD score and overall CLDQ score. Both encephalopathy (correlation coefficient = -.713, P = .004) and ascites (correlation coefficient = -.68, P = .006) were predictive of the QOL using CLDQ (adjusted R(2) = .1494 and f = 0.000). In conclusion, in liver transplant candidates, the severity of liver disease assessed by the MELD score was not predictive of QOL. The presence of ascites and/or encephalopathy was significantly associated with poor quality of life. CTP correlates better to QOL, probably because it contains ascites and encephalopathy.
authors.affiliation: Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, CA 90095, USA. SSaab@mednet.ucla.edu
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
authors.forename: Ayman B
authors.initials: AB
authors.lastname: Ibrahim
authors.forename: Alexander
authors.initials: A
authors.lastname: Shpaner
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
authors.forename: Cindy
authors.initials: C
authors.lastname: Lee
authors.forename: Francisco
authors.initials: F
authors.lastname: Durazo
authors.forename: Steven
authors.initials: S
authors.lastname: Han
authors.forename: Karl
authors.initials: K
authors.lastname: Esrason
authors.forename: Victor
authors.initials: V
authors.lastname: Wu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hiatt
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Farmer
authors.forename: R Mark
authors.initials: RM
authors.lastname: Ghobrial
authors.forename: Curtis
authors.initials: C
authors.lastname: Holt
authors.forename: Hasan
authors.initials: H
authors.lastname: Yersiz
authors.forename: Leonard I
authors.initials: LI
authors.lastname: Goldstein
authors.forename: Myron J
authors.initials: MJ
authors.lastname: Tong
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Busuttil
mesh_terms: D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement