Sluggish decline in a post-transplant model for end-stage liver disease score is a predictor of mortality in living donor liver transplantation / 대한마취과학회지
Korean Journal of Anesthesiology
;
: 160-166, 2010.
Article
in English
| WPRIM
| ID: wpr-170582
ABSTRACT
BACKGROUND:
The pre-transplant model for end-stage liver disease (pre-MELD) score is controversial regarding its ability to predict patient mortality after liver transplantation (LT). Prominent changes in physical conditions through the surgery may require a post-transplant indicator for better mortality prediction. We aimed to investigate whether the post-transplant MELD (post-MELD) score can be a predictor of 1-year mortality.METHODS:
Perioperative variables of 269 patients with living donor LT were retrospectively investigated on their association with 1-year mortality. Post-MELD scores until the 30th day and their respective declines from the 1st day post-MELD score were included along with pre-MELD, acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment (SOFA) scores on the 1st post-transplant day. The predictive model of mortality was established by multivariate Cox's proportional hazards regression.RESULTS:
The 1-year mortality rate was 17% (n = 44), and the leading cause of death was graft failure. Among prognostic indicators, only post-MELD scores after the 5th day and declines in post-MELD scores until the 5th and 30th day were associated with mortality in univariate analyses (P or =24 hours were the earliest independent predictors of 1-year mortality.CONCLUSIONS:
A sluggish decline in post-MELD scores during the early post-transplant period may be a meaningful prognostic indicator of 1-year mortality after LT.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Respiration, Artificial
/
Multivariate Analysis
/
Retrospective Studies
/
Cause of Death
/
Liver Transplantation
/
APACHE
/
Living Donors
/
Transplants
/
Liver
/
Liver Diseases
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Korean Journal of Anesthesiology
Year:
2010
Type:
Article
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