Is MELD score sufficient to predict not only death on waiting list, but also post-transplant survival?
Article first published online: 27 MAR 2006
Volume 19, Issue 4, pages 275–281, April 2006
How to Cite
Silberhumer, G. R., Hetz, H., Rasoul-Rockenschaub, S., Peck-Radosavljevic, M., Soliman, T., Steininger, R., Muehlbacher, F. and Berlakovich, G. A. (2006), Is MELD score sufficient to predict not only death on waiting list, but also post-transplant survival?. Transplant International, 19: 275–281. doi: 10.1111/j.1432-2277.2006.00250.x
- Issue published online: 27 MAR 2006
- Article first published online: 27 MAR 2006
- Received: 28 June 2005 Revision requested: 22 July 2005 Accepted: 24 October 2005
- liver transplantation;
- MELD score;
- risk factors;
- waiting list
Model for end-stage liver disease (MELD) score has emerged as a useful tool in predicting mortality in patients awaiting liver transplantation. There is still, however, discussion as to whether further parameters could improve the sensitivity and specificity of the MELD score. From 1997 to 2003, 621 adult patients with end-stage liver disease were listed for orthotopic liver transplantation (OLT). Patients suffering from hepatoma were excluded from analysis (113 patients). The MELD score was investigated at the time of listing (MELD ON) and of coming off the list (MELD OFF). Patients who died while on the waiting list showed a significant increase in their MELD score during the waiting time (MELD ON: 21 ± 7 vs. MELD OFF: 28 ± 9) as well as a significantly higher MELD ON compared with patients who were transplanted (MELD ON: 16 ± 5 vs. MELD OFF: 17 ± 7) or removed from the waiting list (MELD ON: 16 ± 6 vs. MELD OFF: 12 ± 3). Multivariate analysis identified MELD ON, ascites and recurrent infection as independent risk factors for death on the waiting list (P < 0.01). MELD score was not identified as a predictor for the post-transplant survival rate. MELD score is a strong predictor for death on the waiting list, but refractory ascites and recurrent infection are independent risk factors, too.