title: Improving Outcomes of Liver Transplantation for Polycystic Disease in MELD Era.
abstract: BACKGROUND
  Liver transplantation (LT) for polycystic liver disease (PLD) has evolved to be an option for treating these patients. Patients with PLD suffer from incapacitating symptoms because of very large liver volumes but liver function is preserved until a late stage.
  
  
  OBJECTIVE
  Herein, we reviewed the outcome of adult patients with PLD who underwent LT in the US comparing pre-MELD (1990-2001) to MELD era (2002-2009).
  
  
  RESULTS
  During this period, only 309 patients underwent LT for PLD. The number of LT for PLD is very low comparing the two eras. The percentage of patients who had combined liver and kidney transplantation (CLKT) for this disease has not changed during MELD era (42.8% vs 38.6%). The waiting time for LT (337 vs 272 days) and CLKT (289 vs 220) has increased in MELD era (p<0.001). In MELD era, 53.4% of LT and 31.2% of CLKT were done as MELD exceptional cases. The allograft and patent survival have significantly improved in MELD era.
  
  
  CONCLUSIONS
  Patients with PLD had marked improvement of their outcomes after LT in MELD era.
authors.affiliation: Division of Organ Transplantation, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Saidi
authors.affiliation: Division of Organ Transplantation, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Jabbour
authors.affiliation: Division of Organ Transplantation, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Shah
authors.affiliation: Division of Organ Transplantation, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Organ Transplantation, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Bozorgzadeh
keywords: Liver transplantation; MELD; Polycystic liver disease; Transplantation outcome