Liver transplant outcome: a comparison between high and low MELD score recipients

David, André Ibrahim; Coelho, Maria Paula Villela; Paes, Ângela Tavares; Leite, Ana Kober Nogueira; Guardia, Bianca Della; Almeida, Márcio Dias de; Meira, Sergio Paiva; Rezende, Marcelo Bruno de; Afonso, R.C.; Ferraz-Neto, Ben-Hur

doi:10.1590/s1679-45082012000100012

Cited by 11 publications

(9 citation statements)

References 23 publications

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“…Regarding the use of blood products, the sixth and seventh dimensions in the ICU and in the operating room, respectively, the score also presented a predictive ability of its use in the studied patients, corroborating what was described by other authors (14,17,19) . In contrast to a study developed in the UK (20) , this study sought to assess the correlations between dimensions and variables according to their degree of dependence, making use of the analysis of variance, which allows for measuring the relationship between elements that are part of the dimensions and other variables.…”

Section: Discussionsupporting

confidence: 89%

“…According to the literature (14,17) , transfusion of more than six units of concentrated red cells has been related to reduced survival following liver transplantation. As observed in the sample studied in relation to this finding, of the 14 deaths in the sample, only two patients did not use this number of units or more than this.…”

Section: Discussionmentioning

confidence: 99%

“…The research instrument was divided into seven data collection dimensions, which constituted the analysis model proposed by the researchers of this study, and whose variables were derived from the specialized literature (16)(17) and the transplantation protocol adopted by the institution. All dimensions contained a sequential ordinal number of the liver transplantation procedure and the hospital general record identifier (RGHC).…”

Section: Data Collectionmentioning

confidence: 99%

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Use of a severity indicator as a predictor of the use of hepatic transplantation resources

Eiras

Barbosa

Leão

et al. 2016

Rev. esc. enferm. USP

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OBJECTIVE To evaluate the use of a severity indicator for end-stage liver disease as a predictor of resource use in a teaching hospital in São Paulo. METHOD Descriptive, retrospective study, classifying independent variables in seven key dimensions: identification/risk rating; length of stay/use of advanced life support; imaging; clinical analysis; special procedures; blood products in the intensive care unit; and in the operating room. The frequencies were analyzed by linear regression analysis of variance to detect relevance due to the dependent variable (severity indicator) in 76 cases seen in 2013. RESULTS Among the variables studied, those that presented relevance due to the functional risk score were laboratory measurements of bilirubin, amylase, transaminase, blood count, creatine phosphokinase (p<0.05), hemotherapy procedures fresh frozen plasma (FFP) and platelet concentrate (p<0.05), and Doppler echocardiography image (p<0.07). CONCLUSION Given the results/objective of this study, it is concluded that the indicator presents a potential predictive capability in the use of postoperative resources of liver receptors in the size, clinical analysis, images and hemotherapy dimensions.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

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Use of a severity indicator as a predictor of the use of hepatic transplantation resources

Eiras

Barbosa

Leão

et al. 2016

Rev. esc. enferm. USP

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“…With the exception of the warm ischemic time, all parameters are readily available before the actual transplantation operation takes place and hence could be included in a refined organ allocation system. In part, these parameters have been already identified as risk factors, since preoperative labMELD scores have been recognized as predictive parameters for patient postoperative survival rate, although no clear correlation between the two was previously identified [9]–[12].…”

Section: Discussionmentioning

confidence: 99%

“…High labMELD-scores were discussed as a possible risk factor for increased postoperative mortality [10], [11] and it has been demonstrated that, in comparision to other procedures, sicker patients who undergo liver transplantation not only consume more resources, but also have a higher probability for postoperative morbidity and mortality [6], [9]. High-MELD patients tend to have longer hospital stays and consume more blood-products [12].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis

et al. 2014

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Background and AimsLiver transplantation is the only curative treatment for end-stage liver disease. While waiting list mortality can be predicted by the MELD-score, reliable scoring systems for the postoperative period do not exist. This study's objective was to identify risk factors that contribute to postoperative mortality.MethodsBetween December 2006 and March 2011, 429 patients underwent liver transplantation in our department. Risk factors for postoperative mortality in 266 consecutive liver transplantations were identified using univariate and multivariate analyses. Patients who were <18 years, HU-listings, and split-, living related, combined or re-transplantations were excluded from the analysis. The correlation between number of risk factors and mortality was analyzed.ResultsA labMELD ≥20, female sex, coronary heart disease, donor risk index >1.5 and donor Na+>145 mmol/L were identified to be independent predictive factors for postoperative mortality. With increasing number of these risk-factors, postoperative 90-day and 1-year mortality increased (0–1: 0 and 0%; 2: 2.9 and 17.4%; 3: 5.6 and 16.8%; 4: 22.2 and 33.3%; 5–6: 60.9 and 66.2%).ConclusionsIn this analysis, a simple score was derived that adequately identified patients at risk after liver transplantation. Opening a discussion on the inclusion of these parameters in the process of organ allocation may be a worthwhile venture.

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The MELD score predicts the short-term and overall survival after liver transplantation in patients with primary sclerosing cholangitis or autoimmune liver diseases

Hoffmann

Hinz

Hillebrand

et al. 2014

Langenbecks Arch Surg

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Liver transplant outcome: a comparison between high and low MELD score recipients

Abstract: High MELD score recipients had an improvement in the glomerular filtration rate after 1 week of liver transplantation.

Cited by 11 publications

References 23 publications

Use of a severity indicator as a predictor of the use of hepatic transplantation resources

Use of a severity indicator as a predictor of the use of hepatic transplantation resources

Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis

The MELD score predicts the short-term and overall survival after liver transplantation in patients with primary sclerosing cholangitis or autoimmune liver diseases

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