title: Impact of model for end-stage liver disease score on long-term survival following liver transplantation for hepatocellular carcinoma.
abstract: OBJECTIVE
  Survival rates after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) have significantly increased after Milan criteria and Model for End-Stage Liver Disease (MELD) score implementation. However, few studies have reported this survival in countries with organ donor shortages over a period of 10 years and long waiting lists.
  
  
  METHODS
  This retrospective analysis of clinical data from 93 consecutive HCC patients who underwent OLT from June 2001 to September 2011 excluded 22 who underwent living donor liver transplantation (LDLT). Seventy-one deceased donor liver transplantations (DDLT) were evaluated before and after the MELD era. Kaplan-Meier analysis was used to plot survival rates. The follow-up was 2 months to 10 years.
  
  
  RESULTS
  The overall survival and recurrence rates at 10 years were 67% and 12.2%, respectively. After MELD, patient survival at 5 years decreased from 70% to 64% and the recurrence rate decreased from 15.3% to 12.5%. The most frequent recurrence sites were lung and liver.
  
  
  CONCLUSIONS
  In our center MELD score implementation had a small impact on long-term survival post OLT for HCC.
authors.affiliation: Liver Transplantation Unit, Bonsucesso General Hospital, Rio de Janeiro, Brazil. roma.joyce@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Roma
authors.forename: E
authors.initials: E
authors.lastname: Balbi
authors.forename: L
authors.initials: L
authors.lastname: Pacheco-Moreira
authors.forename: I
authors.initials: I
authors.lastname: Zyngier
authors.forename: A
authors.initials: A
authors.lastname: Araujo
authors.forename: L
authors.initials: L
authors.lastname: Agoglia
authors.forename: K
authors.initials: K
authors.lastname: Steinbruck
authors.forename: L G
authors.initials: LG
authors.lastname: Velaverde
authors.forename: J M
authors.initials: JM
authors.lastname: Martinho
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014850:Waiting Lists