Comparative Study on Liver Transplantation With and Without Hepatocellular Carcinoma With Cirrhosis: Analysis of Meld, Waiting Time and Survival

Freitas, Alexandre Coutinho Teixeira de; Shiguihara, Rafael Shinmi; Monteiro, Ruan Teles; Pazeto, Thiago Linck; Coelho, Júlio Cézar Uili

doi:10.1590/0102-6720201600010006

Cited by 6 publications

(6 citation statements)

References 34 publications

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“…It was seen that MELD ≤ 9 was associated with 10% mortality and 51% with MELD >9.6. In a recent study conducted in Brazil on 138 cases, out of which 28 had cirrhosis related HCC and it was reported that, three months and one year survival rates were 85.7% and 78.6% respectively for HCC patients [9].…”

Section: Discussionmentioning

confidence: 99%

Frequency of High MELD Score in Cirrhotic Patients undergoing Liver Resection due to Hepatocellular Carcinoma

Farooq¹,

Ahmed²,

Nadeem³

et al. 2021

PJMHS

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Objective: To determine the frequency of high MELD score in cirrhotic patients undergoing liver resection due to hepatocellular carcinoma also compare the frequency of mortality in patients with high or low MELD score. Study Design: Cross sectional study Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital, Lahore. Duration: 6months i.e. 23 12-2017 to 22-06-2018. Methodology: 75 patients were enrolled. Then blood sample was obtained. Reports assessed and MELD score calculated. Scores were labeled as high or low. Patients underwent liver resection according to BCLC. The mortality was noted. All the collected data was entered and analyzed on SPSS version 22. Results: In this study out of total 75 cases 60 were males and 15 females. The mean age of patients was 39.44±9.76 years, male to female ratio was 4:1. Low MELD class was noted in 45 (60%) cases and high MELD class noted in 30(40%) cases. Mortality occurred in 27(36%) cases. Insignificant difference found between the MELD class with mortality. Conclusion: High MELD score was seen in 40% cirrhotic patients undergoing liver resection due to HCC. Post HCC resection, mortality occurred in 36% patients within three months of surgery. No significant association was found between the mortality and MELD score. Keywords: MELD, Hepatocellular Carcinoma, Mortality, Cirrhosis

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Section: Discussionmentioning

confidence: 99%

Frequency of High MELD Score in Cirrhotic Patients undergoing Liver Resection due to Hepatocellular Carcinoma

Farooq¹,

Ahmed²,

Nadeem³

et al. 2021

PJMHS

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“…Additional points are thus added to the score to compensate for the higher risk of being without criteria for liver transplantation for reason of a tumor or metastasis, benefiting these patients without disadvantaging other cases. It is worth noting that the waiting time for transplantation has shortened considerably in MELD era, leading to higher survival rates 1 , 5 , 15 , 23 , 28 .…”

Section: Discussionmentioning

confidence: 99%

The Impact of the Meld Score on Liver Transplant Allocation and Results: An Integrative Review

Moraes

Oliveira

Fonseca-Neto

2017

ABCD, arq. bras. cir. dig.

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Introduction: Liver transplantation is intended to increase the survival of patients with chronic liver disease in terminal phase, as well as improved quality of life. Since the first transplant until today many changes have occurred in the organ allocation system. Objective:To review the literature on the Model for End-stage Liver Disease (MELD) and analyze its correlation with survival after liver transplantation. Method:An integrative literature review in Lilacs, SciELO, and Pubmed in October 2015, was realized. Were included eight studies related to the MELD score and its impact on liver transplant. Results:There was predominance of transplants in male between 45-55 y. The main indications were hepatitis C, hepatocellular carcinoma and alcoholic cirrhosis. The most important factors post-surgery were related to the MELD score, the recipient age, expanded donor criteria and hemotransfusion. Conclusion:The MELD system reduced the death rate in patients waiting for a liver transplant. However, this score by itself is not a good predictor of survival after liver transplantation.

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“…A few studies have linked real MELD with survival of the transplanted patient, since this value has no influence on the waiting list due to the extra marks for HCC 12 , 26 . Todo et al in Japan, presented a study in patients with HCC underwent living donor liver transplantation demonstrating that the real MELD influenced survival 26 .…”

Section: Discussionmentioning

confidence: 99%

“…These cases were classified as special situation and have received extra points, reaching the top of the waiting list for liver transplantation 5 , 12 , 15 , 23 .…”

Section: Introductionmentioning

confidence: 99%

Liver Transplantation for Carcinoma Hepatocellular in São Paulo: 414 Cases by the Milan/Brazil Criteria

Sá

Vicentine

Netto

et al. 2016

ABCD, arq. bras. cir. dig.

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Background: The criterion of Milan (CM) has been used as standard for indication of liver transplantation (LTx) for hepatocellular carcinoma (HCC) worldwide for nearly 20 years. Several centers have adopted criteria expanded in order to increase the number of patients eligible to liver transplantation, while maintaining good survival rates. In Brazil, since 2006, the criterion of Milan/Brazil (CMB), which disregards nodules <2 cm, is adopted, including patients with a higher number of small nodules. Aim: To evaluate the outcome of liver transplantation within the CMB. Methods: The medical records of patients with HCC undergoing liver transplantation in relation to recurrence and survival by comparing CM and CMB, were analyzed. Results: 414 LTx for HCC, the survival at 1 and 5 years was 84.1 and 72.7%. Of these, 7% reached the CMB through downstaging, with survival at 1 and 5 years of 93.1 and 71.9%. The CMB patient group that exceeded the CM (8.6%) had a survival rate of 58.1% at five years. There was no statistical difference in survival between the groups CM, CMB and downstaging. Vascular invasion (p<0.001), higher nodule size (p=0.001) and number of nodules >2 cm (p=0.028) were associated with relapse. The age (p=0.001), female (p<0.001), real MELD (p<0.001), vascular invasion (p=0.045) and number of nodes >2 cm (p<0.014) were associated with worse survival. Conclusions: CMB increased by 8.6% indications of liver transplantation, and showed survival rates similar to CM.

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Comparative Study on Liver Transplantation With and Without Hepatocellular Carcinoma With Cirrhosis: Analysis of Meld, Waiting Time and Survival

Cited by 6 publications

References 34 publications

Frequency of High MELD Score in Cirrhotic Patients undergoing Liver Resection due to Hepatocellular Carcinoma

Frequency of High MELD Score in Cirrhotic Patients undergoing Liver Resection due to Hepatocellular Carcinoma

The Impact of the Meld Score on Liver Transplant Allocation and Results: An Integrative Review

Liver Transplantation for Carcinoma Hepatocellular in São Paulo: 414 Cases by the Milan/Brazil Criteria

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