A High MELD Score, Combined with the Presence of Hepatitis C, is Associated with a Poor Prognosis in Living Donor Liver Transplantation

Overview

Journal Surg Today

Specialty General Surgery

Date 2013 Feb 26

PMID 23435837

Citations 5

Authors

Toru Ikegami

Ken Shirabe

Shohei Yoshiya

Tomoharu Yoshizumi

Yo-Ichi Yamashita

Norifumi Harimoto

Takeo Toshima

Hideaki Uchiyama

Yuji Soejima

Yoshihiko Maehara

Affiliations

Soon will be listed here.

Abstract

Purpose: The feasibility of performing living donor liver transplantation (LDLT) for patients with high end-stage liver disease (MELD) scores needs to be assessed.

Methods: A total of 357 patients who underwent LDLT were included in this analysis.

Results: Overall, 46 patients had high MELD scores (≥ 25) and their graft survival was similar to that in patients with low MELD scores (<25; n = 311; p = 0.395). However, among patients with high MELD scores, a multivariate analysis showed that the presence of hepatitis C (p = 0.013) and LDLT in Era-I (p = 0.036) was significantly associated with a poorer prognosis. Among patients with hepatitis C (n = 155), the 5-year graft survival rate was significantly lower in patients with high MELD scores (33.7 %, p < 0.001) than in patients with low MELD scores. The 5-year graft survival rate was significantly lower in patients in Era-I (n = 119) compared with those in Era-II/III when stratified by low (73.0 vs. 82.5 %, p = 0.040) and high (55.0 vs. 86.1 %, p = 0.023) MELD scores. Among the patients with high MELD scores, those with hepatitis C and LDLT in Era-I had the worst 5-year graft survival rate (14.3, p < 0.001).

Conclusion: The graft outcomes in patients with high MELD scores and the presence of hepatitis C were found to be particularly poor.

Citing Articles

Clinical validation of preoperative serum markers for liver fibrosis in living donor liver transplantation recipients.

Tomino T, Itoh S, Toshima T, Yoshiya S, Bekki Y, Iseda N Surg Today. 2024; .

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Vitamin D status as a predictor for liver transplant outcomes.

Fotros D, Sohouli M, Yari Z, Sakhdari H, Shafiekhani M, Nikoupour H Sci Rep. 2023; 13(1):21018.

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Identification of Novel and Noninvasive Biomarkers of Acute Cellular Rejection After Liver Transplantation by Protein Microarray.

Okubo K, Wada H, Tanaka A, Eguchi H, Hamaguchi M, Tomokuni A Transplant Direct. 2016; 2(12):e118.

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Underutilization of Living Donor Liver Transplantation in the United States: Bias against MELD 20 and Higher.

Perumpail R, Yoo E, Cholankeril G, Hogan L, Deis M, Concepcion W J Clin Transl Hepatol. 2016; 4(3):169-174.

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[Right lobe hemihepatectomy as living donor : video article].

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