title: Impact of the Model for End-stage Liver Disease (MELD) score on liver transplantation in Greece.
abstract: BACKGROUND
  The impact of preoperative Model for End-stage Liver Disease (MELD) score in postoperative mortality remains unclear. The assumption that patients with a higher MELD score will have a higher mortality rate is not confirmed and studies are contradictory.
  
  
  OBJECTIVE
  The study of the clinical course of patients with a higher MELD score and its impact in immediate and later mortality in comparison with patients with a lower MELD score in the only liver transplantation center in Greece.
  
  
  METHODS
  We retrospectively studied 71 patients who underwent orthotopic liver transplantation (OLT) in the time period between 1-1-2011 and 31-12-2013. The patients were divided into 2 groups: Group A with a MELD score ≥23 and Group B with a MELD score <23.
  
  
  RESULTS
  In the patients with a MELD score ≥23 the duration of mechanical ventilation and length of stay in the ICU were prolonged (P = .013 and .009, respectively), the transfusions were more (P = .005), and the rates of ICU readmissions (22.5% vs 7.31%, P = .001) and infections (42.5% vs 17.5%, P = .011) were higher. Thirty-day mortality did not differ between the 2 groups (P = .420), but there was a statistically significant difference in morbidity and in 180-day mortality.
  
  
  CONCLUSIONS
  The patients with a higher MELD score have more complex pathophysiology. This score seems to affect morbidity and late, but not early, mortality.
authors.affiliation: Intensive Care Unit "Hippokratio" Hospital, Thessaloniki, Greece. Electronic address: aretikarapan@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Karapanagiotou
authors.affiliation: Intensive Care Unit "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Kydona
authors.affiliation: Department of Nephrology "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Dimitriadis
authors.affiliation: Intensive Care Unit "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Papadopoulos
authors.affiliation: Intensive Care Unit "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Theodoridou
authors.affiliation: Intensive Care Unit "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Tholioti
authors.affiliation: Department of Surgery and Transplantation "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Fouzas
authors.affiliation: Department of Surgery and Transplantation "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Imvrios
authors.affiliation: Intensive Care Unit "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Gritsi-Gerogianni
mesh_terms: D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors