title: Living donor liver transplant versus cadaveric liver transplant survival in relation to model for end-stage liver disease score.
abstract: BACKGROUND
  The Model for End-Stage Liver Disease (MELD) score is universally used to prioritize patients on the liver transplant waiting list. It is potentially used to predict survival as well. There has been conflicting evidence on the use of living donor liver transplantation (LDLT) in patients with high MELD scores. We reported retrospective data comparing survival between LDLT and deceased donor liver transplantation (DDLT) In relation to MELD score in a single-center experience.
  
  
  METHODS
  We retrospectively reviewed our records from 2001 to 2013 for LDLT and DDLT. Data reviewed include the numbers of patients for LDLT and DDLT, age, sex, MELD score, etiology of liver disease, hepatocellular carcinoma, re-transplantation, median follow-up, mortality (with 1 month, 1 year, or after 1 year), and cause of death. Only adults are included in this analysis. Patients were categorized into MELD scores above and below 25. Kaplan-Meier analysis was used for survival, and the log-rank χ(2) test was used for comparison, with a value of P < .05 used for significance.
  
  
  RESULTS
  The total number of transplanted patients at King Faisal Specialist Hospital, Riyadh, Saudi Arabia, was 491. There were 222 patients for LDLT and 269 patients for DDLT. The median age was 53 years (15-80 years), and 292 were male (59.5%). The overall 1-, 3-, and 5-year Kaplan-Meier survival rates of LDLT and DDLT were 89%, 85%, and 84%, respectively, for MELD score below 25, and 80%,78%, and 77%, respectively, for MELD score greater than or equal to 25.
  
  
  CONCLUSIONS
  Our data showed no difference between the survival rates of the two groups (DDLT versus LDLDT), nor that high MELD score has a negative impact on survival. A larger cohort of patients may be needed to confirm these findings.
authors.affiliation: Department of Liver and SB Transplantation and HBP Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Electronic address: mohammed@alsebayel.com.
authors.forename: M
authors.initials: M
authors.lastname: Al Sebayel
authors.affiliation: Department of Liver and SB Transplantation and HBP Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: F
authors.initials: F
authors.lastname: Abaalkhail
authors.affiliation: Department of Medicine, Jeddah University, Jeddah, Saudi Arabia.
authors.forename: A
authors.initials: A
authors.lastname: Hashim
authors.affiliation: Department of Liver and SB Transplantation and HBP Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: H
authors.initials: H
authors.lastname: Al Bahili
authors.affiliation: Organ Transplant Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: S
authors.initials: S
authors.lastname: Alabbad
authors.affiliation: Department of Biostatistics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: M
authors.initials: M
authors.lastname: Shoukdy
authors.affiliation: Department of Liver and SB Transplantation and HBP Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: H
authors.initials: H
authors.lastname: Elsiesy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012529:Saudi Arabia; D012720:Severity of Illness Index; D015996:Survival Rate; D055815:Young Adult