title: Patients' Age Rather Than Model of End-Stage Liver Disease Score Predicts Survival After Liver Transplantation.
abstract: The model of end-stage liver disease (MELD) score is the standard tool for prioritizing patients awaiting liver transplantation. There is currently no definite high cutoff score reflecting disease severity that might exclude patients from transplantation. Furthermore, the age limit that used to disqualify patients from eligibility to transplantation was recently withdrawn in several countries.
  
  
  
  The aims of this study were to assess the effects of MELD score and age at time of transplantation on patients' short- and long-term survival.
  
  
  
  We conducted a retrospective single-center study on a cohort of patients transplanted for the first time due to non-fulminant liver failure.
  
  
  
  Four hundred and seventeen patients (mean age 50.2 years, 63% males) who underwent liver transplantation for the first time were included. Both higher patients' and donors' age were significantly associated with increased long-term mortality (p = 0.007, 95% CI 1.006-1.038 for patient age, p = 0.02, 95% CI 1.002-1.023 for donor age). Patients' age remained significantly associated with survival at 1 year post-transplantation, as well. We found no association between higher MELD score at transplantation and long-term mortality (p = 0.189, 95% CI 0.99-1.051) irrespective of patients' age. Specifically, when patients were divided according to their MELD score at transplantation (MELD < 15, MELD 15-25 and MELD > 25), no significant differences in long-term survival were detected between these three subgroups. Results did not differ significantly in a subgroup analysis of patients without hepatocellular carcinoma at the time of transplantation.
  
  
  
  Patients' and donors' age rather than patients' MELD score at transplantation determine survival following liver transplantation.
authors.affiliation: Department of Internal Medicine D, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petah-Tikva, 49100, Israel. yaara.lk@gmail.com.|Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. yaara.lk@gmail.com.
authors.forename: Yaara
authors.initials: Y
authors.lastname: Leibovici-Weissman
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.|Department of Transplantation, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel.
authors.forename: Eytan
authors.initials: E
authors.lastname: Mor
authors.affiliation: Tel-Aviv University School of Management, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Leshno
authors.affiliation: Department of Internal Medicine D, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petah-Tikva, 49100, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.|The Liver Institute, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Shlomai
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D058625:End Stage Liver Disease / Q000276:immunology / Q000401:mortality / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D012107:Research Design; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data
keywords: Age factor; Graft survival; Hepatic transplantation; MELD score; Patient survival