title: A high model for end-stage liver disease score should not be considered a contraindication to living donor liver transplantation.
abstract: OBJECTIVE
  To analyze the outcomes of patients with high Model for End-Stage Liver Disease (MELD) scores who underwent adult-to-adult live donor liver transplantation (A-A LDLT).
  
  
  METHODS
  From September 2002 to October 2010, a total of 152 adult patients underwent A-A LDLT in our institution. Recipients were stratified into a low MELD score group (Group L; MELD score≤30) and a high MELD score group (Group H; MELD score>30) to compare short-term and long-term outcomes.
  
  
  RESULTS
  Of the 152 adult patients who underwent A-A LDLT, 9 were excluded from the analysis because they received ABO-incompatible grafts. Group H comprised 23 and Group L 120 patients. The median follow-up was 21.5 months (range, 3 to 102 m). The mean MELD score was 15.6 in Group L and 36.7 in Group H. There were no significant differences in the mean length of stay in the intensive care unit (Group L: 3.01 days vs Group H: 3.09 days, P=.932) or mean length of hospital stay (Group L: 17.89 days vs. Group H: 19.91 days, P=0.409). There were no significant differences in 1-, 3-, or 5-year survivals between patients in Groups L versus H (91.5% vs 94.7%; 86.4% vs 94.7%; and 86.4% vs 94.7%; P=.3476, log rank).
  
  
  CONCLUSIONS
  The short-term and long-term outcomes of patients with high MELD scores who underwent A-A LDLT were similar to those of patients with low MELD scores. Therefore, we suggest that high MELD scores are not a contraindication to LDLT.
authors.affiliation: Organ Transplantation Center, Department of Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors.forename: K-S
authors.initials: KS
authors.lastname: Poon
authors.forename: T-H
authors.initials: TH
authors.lastname: Chen
authors.forename: L-B
authors.initials: LB
authors.lastname: Jeng
authors.forename: H-R
authors.initials: HR
authors.lastname: Yang
authors.forename: P-C
authors.initials: PC
authors.lastname: Li
authors.forename: C-C
authors.initials: CC
authors.lastname: Lee
authors.forename: C-C
authors.initials: CC
authors.lastname: Yeh
authors.forename: H-C
authors.initials: HC
authors.lastname: Lai
authors.forename: W-P
authors.initials: WP
authors.lastname: Su
authors.forename: C Y
authors.initials: CY
authors.lastname: Peng
authors.forename: Y-F
authors.initials: YF
authors.lastname: Chen
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Ho
authors.forename: P-P
authors.initials: PP
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000075202:Contraindications; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome