Liver - Original Article

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

Volume 31 · Issue 11 Publish Date: November 15, 2020
Şencan Acar Murat Akyıldız Ahmet Gürakar Yaman Tokat Murat Dayangaç
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Turkish Journal of Gastroenterology

Volume 31 · Issue 11

Pages: 782-789

History

Published Online: November 15, 2020

Copyright © 2020 Şencan Acar, Murat Akyıldız, Ahmet Gürakar, Yaman Tokat, Murat Dayangaç

Şencan Acar
Department of Gastroenterology and Hepatology Section of Transplant Hepatology Johns Hopkins University School of Medicine Baltimore MD USA
Murat Akyıldız
Departments of Gastroenterology, Ege University, School of Medicine, İzmir
Ahmet Gürakar
Division of Liver Transplantation Medicine/Hepatology, Nazih Zuhdi Transplantation Institute, Integris Baptist Medical Center, Oklahoma City, OK.
Yaman Tokat
Ege University Medical School, Departments of General Surgery, İzmir
Murat Dayangaç
Department of Surgery, Ege University Medical Faculty, Izmir
Acar, Şencan, Akyıldız, M., Gürakar, A., Tokat, Y., & Dayangaç, M. (2020). Delta MELD as a predictor of early outcome in adult-to-adult living donor liver transplantation. Turkish Journal of Gastroenterology, 31(11), 782–789. https://doi.org/10.5152/tjg.2020.18761
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Abstract

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.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 31 · Issue 11
Pages 782-789
DOI 10.5152/tjg.2020.18761
History
Published Online November 15, 2020
Copyright
Copyright (c) 2020 Şencan Acar, Murat Akyıldız, Ahmet Gürakar, Yaman Tokat, Murat Dayangaç
Affiliations
Şencan Acar
Department of Gastroenterology and Hepatology Section of Transplant Hepatology Johns Hopkins University School of Medicine Baltimore MD USA
Murat Akyıldız
Departments of Gastroenterology, Ege University, School of Medicine, İzmir
Ahmet Gürakar
Division of Liver Transplantation Medicine/Hepatology, Nazih Zuhdi Transplantation Institute, Integris Baptist Medical Center, Oklahoma City, OK.
Yaman Tokat
Ege University Medical School, Departments of General Surgery, İzmir
Murat Dayangaç
Department of Surgery, Ege University Medical Faculty, Izmir
Cite this Article
Acar, Şencan, Akyıldız, M., Gürakar, A., Tokat, Y., & Dayangaç, M. (2020). Delta MELD as a predictor of early outcome in adult-to-adult living donor liver transplantation. Turkish Journal of Gastroenterology, 31(11), 782–789. https://doi.org/10.5152/tjg.2020.18761
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