MELD fails to measure quality of life in liver transplant candidates.
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.
Saab
Sammy
S
Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, CA 90095, USA. SSaab@mednet.ucla.edu
Ibrahim
Ayman B
AB
Shpaner
Alexander
A
Younossi
Zobair M
ZM
Lee
Cindy
C
Durazo
Francisco
F
Han
Steven
S
Esrason
Karl
K
Wu
Victor
V
Hiatt
Jonathan
J
Farmer
Douglas G
DG
Ghobrial
R Mark
RM
Holt
Curtis
C
Yersiz
Hasan
H
Goldstein
Leonard I
LI
Tong
Myron J
MJ
Busuttil
Ronald W
RW
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