title: D-MELD does not predict post-liver transplantation survival: a single-center experience from Brazil.
abstract: BACKGROUND
  The D-MELD score was designed to prevent donor-recipient matches with a high risk of unfavorable outcome. The main objective of the present study was to assess the predictive value of the DMELD score for 1-month and 3-month post-transplant mortality in a cohort of patients who underwent deceased-donor liver transplantation in Southern Brazil.
  
  
  METHODS
  A cohort study was conducted. Receiver operating characteristic c-statistics were used to determine the ability of the D-MELD score to predict mortality. The Kaplan-Meier method was used to analyze survival as a function of time regarding D-MELD scores, and the Cox model was employed to assess the association between D-MELD and mortality.
  
  
  RESULTS
  Most recipients were male, with a mean age of 54.3 ± 9.6 years (n = 233 transplants). Mean donor age was 44.9 ± 16.8 years (19.3% of donors were aged ≥ 60 years). Mean MELD and D-MELD scores were 16.3 ± 7.1 and 733.1 ± 437.8 respectively. Overall survival at 1 and 3 months was 83.6%. The c-statistic value for 1- and 3-month mortality was < 0.5 for the D-MELD. Analysis of Kaplan-Meier curves for groups with D-MELD scores < 1,600 and ≥ 1,600 did not show statistically significant differences in survival (p = 0.722).
  
  
  CONCLUSIONS
  D-MELD scores were unable to predict survival in this cohort of Brazilian liver transplant recipients.
authors.affiliation: Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Ane M
authors.initials: AM
authors.lastname: Costabeber
authors.affiliation: Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Lívia C
authors.initials: LC
authors.lastname: Lionço
authors.affiliation: Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Liver Transplantation Group, Santa Casa de Misericórdia de Porto Alegre, RS, Brazil.
authors.forename: Cláudio
authors.initials: C
authors.lastname: Marroni
authors.affiliation: Liver Transplantation Group, Santa Casa de Misericórdia de Porto Alegre, RS, Brazil.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Zanotelli
authors.affiliation: Liver Transplantation Group, Santa Casa de Misericórdia de Porto Alegre, RS, Brazil.
authors.forename: Guido
authors.initials: G
authors.lastname: Cantisani
authors.affiliation: Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Liver Transplantation Group, Santa Casa de Misericórdia de Porto Alegre, RS, Brazil.
authors.forename: Ajácio
authors.initials: A
authors.lastname: Brandão
mesh_terms: D000328:Adult; D001938:Brazil; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate