title: Is Model for End-Stage Liver Disease score associated with quality of life after liver transplantation?
abstract: BACKGROUND
  The Model for End-Stage Liver Disease (MELD) is used to predict short-term mortality of patients on the liver transplant waiting list and to allocate deceased donor livers for transplantation.
  
  
  OBJECTIVE
  To examine the relationship between MELD score before transplant and quality of life and other functional status indicators after transplant.
  
  
  METHODS
  Two-hundred sixty-five adults from 2 transplant programs completed quality-of-life measures 1 year after transplantation. A subcohort (n = 115) also completed quality-of-life assessments before transplant. Clinical parameters at the time of transplantation were collected from their medical records.
  
  
  METHODS
  Short Form-36 Health Survey, version 2; Transplant Symptom Frequency Questionnaire.
  
  
  RESULTS
  Patients with MELD scores greater than 25 at transplantation had significantly higher scores on the Short Form-36 general health (P = .004) and physical component summary (P = .02) than did patients with MELD scores of 25 or less. However, scores on the Transplant Symptom Frequency Questionnaire did not vary significantly by MELD score. Child-Turcotte-Pugh (CTP) score, a measure of disease severity, was significantly associated with total symptom frequency after transplant (P = .03) but was not correlated with any domains on the Short Form-36. In the subcohort of 115 patients, a MELD score greater than 25 at the time of transplantation was associated with greater improvement in physical functioning (11.3 vs 4.8, P = .02), role functioning-physical (10.7 vs 4.7, P = .04), general health (11.9 vs 5.5, P = .03), vitality (10.4 vs 5.2, P = .02), and physical component summary (12.3 vs 5.4, P = .01) relative to patients with MELD scores of 15 to 25.
  
  
  CONCLUSIONS
  The relationship between disease severity before transplant and quality of life after transplant is different depending on the index of disease severity used (MELD vs CTP) and whether the assessment of quality of life is general or specific to transplant-related symptoms.
authors: Beth Israel Deaconess Medical Center Boston, Massachusetts 02215, USA. jrrodrig@bidmc.harvard.edu
authors: James R
authors: JR
authors: Rodrigue
authors: David R
authors: DR
authors: Nelson
authors: Alan I
authors: AI
authors: Reed
authors: Douglas W
authors: DW
authors: Hanto
authors: Michael P
authors: MP
authors: Curry
mesh_terms: D016022:Case-Control Studies; D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005431:Florida; D006801:Humans; D016014:Linear Models; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index