Turkish Journal of Gastroenterology
Liver - Original Article

Delta MELD as a predictor of early outcome in adult-to-adult living donor liver transplantation

1.

Department of Gastroenterology and Hepatology, Section of Transplant Hepatology, Johns Hopkins University School of Medicine Baltimore, MD, USA

2.

Department of Gastroenterology and Organ Transplantation Center, Sakarya University School of Medicine, Sakarya, Turkey

3.

Department of Gastroenterology and Organ Transplantation Center, Koc University School of Medicine, İstanbul, Turkey

4.

Department of General Surgery and Liver Transplantation Unit, Florence Nightingale Hospital, Istanbul Bilim University, İstanbul, Turkey

5.

Department of General Surgery and Liver Transplantation Unit, Medipol Mega University Hospital, İstanbul, Turkey

Turk J Gastroenterol 2020; 31: 782-789
DOI: 10.5152/tjg.2020.18761
Read: 187 Downloads: 103 Published: 14 December 2020

Background/Aims: An increased post-operative mortality risk has been reported among patients who undergo living donor liver transplantation (LDLT) with higher model for end-stage liver disease (MELD) scores. In this study, we investigated the effect of MELD score reduction on post-operative outcomes in patients with a high MELD (≥20) score by pre-transplant management.

Materials and Methods: We retrospectively analyzed 386 LDLT cases, and patients were divided into low-MELD (<20, n=293) vs. high-MELD (≥20, n=93) groups according to their MELD score at the time of index hospitalization. Patients in the high-MELD group were managed specifically according to a treatment algorithm in an effort to decrease the MELD score. Patients in the high-MELD group were further divided into 2 subgroups: (1) responders (n=34) to pre-transplant treatment with subsequent reduction of the MELD score by a minimum of 1 point vs. (2) non-responders (n=59), whose MELD score remained unchanged or further increased on the day of LDLT. Responders vs. non-responders were compared according to etiology, demographics, and survival. 

Cite this article as: Acar Ş, Akyıldız M, Gürakar A, Tokat Y, Dayangaç M. Delta MELD as a predictor of early outcome in adult-to-adult living donor liver transplantation. Turk J Gastroenterol 2020; 31(11): 782-9.

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