title: Model for End-Stage Liver Disease (MELD) score does not predict outcomes of hepatitis B-induced acute-on-chronic liver failure in transplant recipients.
abstract: BACKGROUND
  Acute-on-chronic liver failure (ACLF) is a severe clinical entity and liver transplantation is the only definitive therapy to salvage these patients. However, the timing of liver transplant for these patients remains unclear.
  
  
  METHODS
  Seventy-eight patients undergoing liver transplantation because of hepatitis B ACLF were retrospectively analyzed from June 2004 to December 2010. The areas under the receiver operating characteristic curve (AUC) of Model for End-Stage Liver Disease (MELD) score and Child-Turcotte-Pugh (CTP) score for the post-transplantation outcomes were calculated.
  
  
  RESULTS
  The median age was 44 years (range, 25-64 years), serum bilirubin 418.53 μmol/L (range, 112.90-971.40 μmol/L), INR 3.177 (range, 1.470-9.850), and creatinine 70.84 μmol/L (range, 12.39-844.1 μmol/L); the median MELD score was 32 (range, 21-53) and CTP score 12 (8-15). The AUCs of MELD and CTP scores for 3-month mortality were 0.581 (95% confidence interval [CI], 0.421-0.742; sensitivity, 87.5%; specificity, 32.8%) and 0.547 (95% CI, 0.401-0.693; sensitivity, 75%; specificity, 41%), respectively. Meanwhile, there were no significant differences in hospital mortality (P = .252) or morbidity (P = .338) between the patients with MELD score ≥30 and those <30.
  
  
  CONCLUSIONS
  MELD score had no predictive ability for the outcomes of patients with hepatitis B ACLF after orthotopic liver transplantation.
authors.affiliation: Department of Hepatobiliary Surgery and You-An Liver Transplant Center, Beijing You-An Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: B-W
authors.initials: BW
authors.lastname: Duan
authors.affiliation: Institute and Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China. Electronic address: lsc620213@aliyun.com.
authors.forename: S-C
authors.initials: SC
authors.lastname: Lu
authors.affiliation: Department of Hepatobiliary Surgery and You-An Liver Transplant Center, Beijing You-An Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: J-S
authors.initials: JS
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary Surgery and You-An Liver Transplant Center, Beijing You-An Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Q-L
authors.initials: QL
authors.lastname: Guo
authors.affiliation: Department of Hepatobiliary Surgery and You-An Liver Transplant Center, Beijing You-An Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: D-B
authors.initials: DB
authors.lastname: Zeng
authors.affiliation: Department of Hepatobiliary Surgery and You-An Liver Transplant Center, Beijing You-An Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: T
authors.initials: T
authors.lastname: Jiang
authors.affiliation: Department of Hepatobiliary Surgery and You-An Liver Transplant Center, Beijing You-An Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: D-G
authors.initials: DG
authors.lastname: Kong
authors.affiliation: Department of Hepatobiliary Surgery and You-An Liver Transplant Center, Beijing You-An Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: J
authors.initials: J
authors.lastname: Ding
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000209:etiology*; D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D066027:Transplant Recipients