title: Liver transplant outcome: a comparison between high and low MELD score recipients.
abstract: OBJECTIVE
  To compare low and high MELD scores and investigate whether existing renal dysfunction has an effect on transplant outcome.
  
  
  METHODS
  Data was prospectively collected among 237 liver transplants (216 patients) between March 2003 and March 2009. Patients with cirrhotic disease submitted to transplantation were divided into three groups: MELD > or = 30, MELD < 30, and hepatocellular carcinoma. Renal failure was defined as a +/- 25% decline in estimated glomerular filtration rate as observed 1 week after the transplant. Median MELD scores were 35, 21, and 13 for groups MELD > or = 30, MELD < 30, and hepatocellular carcinoma, respectively.
  
  
  RESULTS
  Recipients with MELD > or = 30 had more days in Intensive Care Unit, longer hospital stay, and received more blood product transfusions. Moreover, their renal function improved after liver transplant. All other groups presented with impairment of renal function. Mortality was similar in all groups, but renal function was the most important variable associated with morbidity and length of hospital stay.
  
  
  CONCLUSIONS
  High MELD score recipients had an improvement in the glomerular filtration rate after 1 week of liver transplantation.
authors.affiliation: Hospital Israelita Albert Einstein - HIAE, São Paulo (SP), Brazil.
authors.forename: Andre Ibrahim
authors.initials: AI
authors.lastname: David
authors.forename: Maria Paula Villela
authors.initials: MP
authors.lastname: Coelho
authors.forename: Angela Tavares
authors.initials: AT
authors.lastname: Paes
authors.forename: Ana Kober
authors.initials: AK
authors.lastname: Leite
authors.forename: Bianca
authors.initials: B
authors.lastname: Della Guardia
authors.forename: Márcio Dias
authors.initials: MD
authors.lastname: de Almeida
authors.forename: Sergio Paiva
authors.initials: SP
authors.lastname: Meira
authors.forename: Marcelo Bruno
authors.initials: MB
authors.lastname: de Rezende
authors.forename: Rogerio Carballo
authors.initials: RC
authors.lastname: Afonso
authors.forename: Ben-Hur
authors.initials: BH
authors.lastname: Ferraz-Neto
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007674:Kidney Diseases / Q000150:complications; D007902:Length of Stay / Q000706:statistics & numerical data; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D003404:Creatinine