title: The MELD score may help to determine optimum time for liver transplantation.
abstract: BACKGROUND
  The model for end-stage liver disease (MELD) score is a good predictor of mortality on the waiting list and short-term survival post liver transplantation.
  
  
  OBJECTIVE
  Our aim was to determine if there is a pretransplant MELD score beyond which liver transplantation is prohibitive.
  
  
  METHODS
  Forty-six adult patients underwent primary liver transplantation from January 1996 to December 2002. Patients followed to the most recent visit or death underwent survival analysis using Cox regression and Kaplan Meier methods.
  
  
  RESULTS
  There was a significant correlation between the pretransplant MELD score and survival at 6 months posttransplant (P=.037 95% CI: 1.004-1.13). Patients with pretransplant MELD score greater than or equal to 32 showed significantly greater mortality compared with those less than 32 (HR 9.18, 95%CI=1.16-72.44).
  
  
  CONCLUSIONS
  Pretransplant MELD may help to determine the optimum time for liver transplantation.
authors.affiliation: Department of Medicine, National University Hospital, Singapore. mdcleeym@nus.edu.sg
authors.forename: Y M
authors.initials: YM
authors.lastname: Lee
authors.forename: M
authors.initials: M
authors.lastname: Fernandes
authors.forename: M
authors.initials: M
authors.lastname: Da Costa
authors.forename: K H
authors.initials: KH
authors.lastname: Lee
authors.forename: D
authors.initials: D
authors.lastname: Sutedja
authors.forename: B C
authors.initials: BC
authors.lastname: Tai
authors.forename: K C
authors.initials: KC
authors.lastname: Tan
authors.forename: J
authors.initials: J
authors.lastname: Isaac
authors.forename: K
authors.initials: K
authors.lastname: Prabhakaran
authors.forename: S G
authors.initials: SG
authors.lastname: Lim
mesh_terms: D000328:Adult; D006801:Humans; D017093:Liver Failure / Q000503:physiopathology* / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome