Pretransplant MELD score as a predictor of outcome after liver transplantation for chronic hepatitis C

Nicholas N. Onaca, Marlon F. Levy, George J. Netto, Mark J. Thomas, Edmund Q. Sanchez, Srinath Chinnakotla, Carlos G. Fasola, Jeffrey S. Weinstein, Natalie Murray, Robert M. Goldstein, Goran B. Klintmalm

Research output: Contribution to journalArticle

Abstract

The Model of End-Stage Liver Disease (MELD) score, an accurate predictor of mortality in patients awaiting liver transplantation (OLTX), did not predict graft or patient survival in the post-transplant setting. Our aim was to test the model in patients who underwent OLTX for chronic hepatitis C. Two hundred and eighty-seven adult patients who underwent primary OLTX for chronic hepatitis C between December 1993 and September 1999 were studied from a prospectively maintained database. The group was stratified by MELD scores of less than 15, 15-24, and greater than 24. Patient survival, graft survival, and interval liver biopsy pathology were reviewed. Both patient and graft survival at 3, 6, and 12 months were significantly lower in the higher MELD score groups, as was patient survival at 24months (p-values, 0.01-0.05). The difference in survival between the low, medium, and high MELD score groups increases in time. The survival without bridging fibrosis in the allograft at 1 year post-transplant was significantly lower with higher MELD scores (p=0.037). The decrease in survival seen in hepatitis C patients with MELD scores greater than 24 raises questions of transplant suitability for these patients. Therapeutic modalities to decrease post-transplant graft injury in these patients should be explored.

Original languageEnglish (US)
Pages (from-to)626-630
Number of pages5
JournalAmerican Journal of Transplantation
Volume3
Issue number5
DOIs
StatePublished - May 2003
Externally publishedYes

Fingerprint

End Stage Liver Disease
Chronic Hepatitis C
Liver Transplantation
Transplants
Survival
Graft Survival
Hepatitis C
Allografts
Fibrosis
Databases
Pathology
Biopsy

Keywords

  • Hepatitis C
  • Liver transplantation
  • Outcome
  • Severity score

ASJC Scopus subject areas

  • Immunology

Cite this

Onaca, N. N., Levy, M. F., Netto, G. J., Thomas, M. J., Sanchez, E. Q., Chinnakotla, S., ... Klintmalm, G. B. (2003). Pretransplant MELD score as a predictor of outcome after liver transplantation for chronic hepatitis C. American Journal of Transplantation, 3(5), 626-630. https://doi.org/10.1034/j.1600-6143.2003.00092.x

Pretransplant MELD score as a predictor of outcome after liver transplantation for chronic hepatitis C. / Onaca, Nicholas N.; Levy, Marlon F.; Netto, George J.; Thomas, Mark J.; Sanchez, Edmund Q.; Chinnakotla, Srinath; Fasola, Carlos G.; Weinstein, Jeffrey S.; Murray, Natalie; Goldstein, Robert M.; Klintmalm, Goran B.

In: American Journal of Transplantation, Vol. 3, No. 5, 05.2003, p. 626-630.

Research output: Contribution to journalArticle

Onaca, NN, Levy, MF, Netto, GJ, Thomas, MJ, Sanchez, EQ, Chinnakotla, S, Fasola, CG, Weinstein, JS, Murray, N, Goldstein, RM & Klintmalm, GB 2003, 'Pretransplant MELD score as a predictor of outcome after liver transplantation for chronic hepatitis C', American Journal of Transplantation, vol. 3, no. 5, pp. 626-630. https://doi.org/10.1034/j.1600-6143.2003.00092.x
Onaca, Nicholas N. ; Levy, Marlon F. ; Netto, George J. ; Thomas, Mark J. ; Sanchez, Edmund Q. ; Chinnakotla, Srinath ; Fasola, Carlos G. ; Weinstein, Jeffrey S. ; Murray, Natalie ; Goldstein, Robert M. ; Klintmalm, Goran B. / Pretransplant MELD score as a predictor of outcome after liver transplantation for chronic hepatitis C. In: American Journal of Transplantation. 2003 ; Vol. 3, No. 5. pp. 626-630.
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