title: Which score system can best predict recipient outcomes after living donor liver transplantation?
abstract: BACKGROUND
  Many scoring systems have been suggested to predict the outcomes of deceased donor liver transplantations. The aims of this study were to compare the Model for End-Stage Liver Disease (MELD) score with respect to other scores among patients who underwent living donor liver transplantation (LDLT) seeking to evaluate the best system to correlate with postoperative outcomes after LDLT.
  
  
  METHODS
  We analyzed retrospectively data from 202 adult patients who underwent LDLT from January 2008 to July 2010. We calculated preoperative MELD, MELD-sodium, MELD to serum sodium ratio (MESO), integrated MELD, United Kingdom MELD, Child-Turcotte-Pugh, Acute Physiology and Chronic Health evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA) scores in all patients. We analyzed the correlation of each score with postoperative laboratory results, as well as survival at 1, 3, 6 and 12 months after LDLT.
  
  
  RESULTS
  There was significant positive correlation between all scores and peak total bilirubin during the first 7 days after LDLT. The MELD score showed the greatest correlation with peak total bilirubin (r=0.745). APACHE II and SOFA scores at 6 months and 1 year after LDLT and MESO score at 1 year after LDLT showed acceptable discrimination performance {area under the receiver operating characteristic curves (AUC)>0.7, while other scoring systems showed poor discrimination. However, the AUCs of each score were not significantly different from the MELD score AUC.
  
  
  CONCLUSIONS
  The MELD score most correlated with total bilirubin after LDLT, while the APACHE II and SOFA scores seemed to correlate with mortality after LDLT.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: I S
authors.initials: IS
authors.lastname: Chung
authors.forename: M
authors.initials: M
authors.lastname: Park
authors.forename: J S
authors.initials: JS
authors.lastname: Ko
authors.forename: M S
authors.initials: MS
authors.lastname: Gwak
authors.forename: G S
authors.initials: GS
authors.lastname: Kim
authors.forename: S-K
authors.initials: SK
authors.lastname: Lee
mesh_terms: D018806:APACHE; D019540:Area Under Curve; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D006305:Health Status Indicators; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D019520:Living Donors; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000401:mortality; D011237:Predictive Value of Tests; D012372:ROC Curve; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001663:Bilirubin