title: MELD and other predictors of survival after liver transplantation.
abstract: BACKGROUND
  This study examined how reliable is the pre-transplant model for end-stage liver disease (MELD) score in predicting post-transplantation survival and analyzed variables associated with patient survival.
  
  
  METHODS
  A cohort study was conducted. Receiver operating characteristic curve c-statistics were used to determine the ability of MELD score to predict mortality. The Kaplan-Meier (KM) method was used to analyze survival as a function of time regarding the MELD score and Child-Turcotte-Pugh (CTP) category. The Cox model was employed to assess the association between baseline risk factors and mortality.
  
  
  RESULTS
  Recipients and donors were mostly male, with a mean age of 51.6 and 38.5 yr, respectively (n = 436 transplants). The c-statistic values for three-month patient mortality were 0.60 and 0.61 for MELD score and CTP category, respectively. KM survival at three, six and 12 months were lower in those who had a MELD score > or =21 or were CTP category C. Multivariate analysis revealed that recipient age > or =65 yr, MELD > or = 21, CTP C category, bilirubin > or = 7 mg/dL, creatinine > or = 1.5 mg/dL, platelet transfusion, hepatocellular carcinoma, and non-white color donor skin were predictors of mortality.
  
  
  CONCLUSIONS
  Severe pre-transplant liver disease, age > or = 65, non-white skin donor, and hepatocellular carcinoma are associated with poor outcome.
authors.affiliation: Liver Transplantation Group, Complexo Hospitalar Santa Casa, Porto Alegre-RS, Brazil. ajaccio@via-rs.net
authors.forename: Ajacio
authors.initials: A
authors.lastname: Brandão
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Fuchs
authors.forename: Ana L
authors.initials: AL
authors.lastname: Gleisner
authors.forename: C
authors.initials: C
authors.lastname: Marroni
authors.forename: Maria L
authors.initials: ML
authors.lastname: Zanotelli
authors.forename: Guido
authors.initials: G
authors.lastname: Cantisani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D017093:Liver Failure / Q000401:mortality* / Q000601:surgery; D008113:Liver Neoplasms / Q000401:mortality* / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult