D-MELD does not predict post-liver transplantation survival: a single-center experience from Brazil
Journal Title: Annals of Hepatology - Year 2014, Vol 13, Issue 6
Abstract
Background. The D-MELD score was designed to prevent donor-recipient matches with a high risk of unfavorable outcome. The main objective of the present study was to assess the predictive value of the DMELD score for 1-month and 3-month post-transplant mortality in a cohort of patients who underwent deceased-donor liver transplantation in Southern Brazil. Material and methods. A cohort study was conducted. Receiver operating characteristic c-statistics were used to determine the ability of the D-MELD score to predict mortality. The Kaplan-Meier method was used to analyze survival as a function of time regarding D-MELD scores, and the Cox model was employed to assess the association between D-MELD and mortality. Results. Most recipients were male, with a mean age of 54.3 ± 9.6 years (n = 233 transplants). Mean donor age was 44.9 ± 16.8 years (19.3% of donors were aged ≥ 60 years). Mean MELD and D-MELD scores were 16.3 ± 7.1 and 733.1 ± 437.8 respectively. Overall survival at 1 and 3 months was 83.6%. The c-statistic value for 1- and 3-month mortality was < 0.5 for the D-MELD. Analysis of Kaplan-Meier curves for groups with D-MELD scores < 1,600 and ≥ 1,600 did not show statistically significant differences in survival (p = 0.722). Conclusion. D-MELD scores were unable to predict survival in this cohort of Brazilian liver transplant recipients.
Authors and Affiliations
Ane M. Costabeber, Lívia C. Lionço, Cláudio Marroni, Maria L. Zanotelli, Guido Cantisani, Ajácio Brandão
The Changing Face of the Diagnosis of Chronic and Malignant Liver Diseases: Potential New Biomarkers
The early diagnosis of primary sclerosing cholangitis, hepatocellular carcinoma, and cholangiocarcinoma is often challenging. In a recent study in 134 patients (Arbelaiz, Hepatology 2017; 66:1125-1143), it was reported t...
Pulmonary vascular clearance of harmful endogenous macromolecules in a porcine model of acute liver failure
Background. Pulmonary complications are common in acute liver failure (ALF). The role of the lungs in the uptake of harmful soluble endogenous macromolecules was evaluated in a porcine model of ALF induced by hepatic de...
How to diagnose hepatic encephalopathy in the emergency department
[b]Introduction[/b]. Blood ammonia-measurements are often performed in the emergency departments to diagnose or rule out hepatic encephalopathy (HE). However, the utility and correct interpretation of ammonia levels is a...
Successful treatment of severe hepatopulmonary syndrome with a sequential use of TIPS placement and liver transplantation
Hepatopulmonary syndrome (HPS) is a complication of portal hypertension (PH) defined by the presence of liver disease, abnormal pulmonary gas exchange and evidence of intrapulmonary vascular dilatations (IPVD) producing...
Adenovirus hepatitis presenting as tumoral lesions in an immunocompromised patient
A 59-year-old man with T-cell prolymphocytic leukemia on alemtuzumab presented with neutropenic fever, intermittent nausea, and multiple ill-defined low attenuation foci in the liver on abdominal computed tomography scan...