![]() ![]() Since February 2002, the United Network for Organ Sharing introduced a new allocation policy for cadaveric liver transplants, based on the model for endstage liver disease (MELD) score. * Correspondence: Surgical Intensive Care Unit, University Hospital of Zurich, Raemistrasse 100, Zürich 8091, Switzerland + Contributed equallyįull list of author information is available at the end of the article The USA and Europe used prioritization systems based on waiting time and on the parameters of the Child-Turcotte-Pugh ![]() Fair allocation of donor livers to patients with end-stage liver disease is a difficult task. As liver transplantation has become a universally accepted treatment for end-stage liver disease, the number of patients accumulating on the waiting list has gradually outweighed the scarce resources of available organs. Liver transplantation is still a complex and cost-intensive procedure and the results are influenced by many interrelated factors. This finding supports the transplantation of patients with high MELD score but only with knowledge of increased morbidity. Postoperative renal failure is a strong predictor of morbidity (OR 7.9) and postoperative renal replacement therapy was highly associated with increased mortality (hazard ratio 6.8), as was hepato renal syndrome prior to transplantation (hazard ratio 13.2).Ĭonclusions: This study identified MELD score greater than 23 as an independent risk factor of morbidity represented by ICU stay longer than 10 days but in contrast had no negative impact on mortality. Furthermore, we identified transfusion of more than 7 units of red blood cells as independent risk factor for mortality (hazard ratio 7.6) and for prolonged ICU stay (odds ratio 7.8) together with transfusion of more than 10 units of fresh frozen plasma (OR 11.6). Results: This study identified MELD score greater than 23 as an independent risk factor of morbidity represented by intensive care unit (ICU) stay longer than 10 days (odds ratio 7.0) but in contrast had no negative impact on mortality. Methods: We retrospectively analyzed data of 144 consecutive liver transplant recipients over a 72-month period in our transplant unit, from January 2003 until December 2008 and performed uni- and multivariate analysis for morbidity and mortality, in particular to define the influence of MELD to these parameters. There are reports of poorer patient outcome in transplant candidates with high MELD score, others though report no influence of MELD score on outcome and survival. Introduction: The impact of model of end stage liver disease (MELD) score on postoperative morbidity and mortality is still elusive, especially for high MELD. Model of end stage liver disease (MELD) score greater than 23 predicts length of stay in the ICU but not mortality in liver transplant recipientsĬhristian E Oberkoflert1, Philipp Dutkowski11, Reto Stocker2, Reto A Schuepbach2, John F Stover2, PierreAlain Clavien1 and Markus Bechir*2 ![]()
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