Model for end-stage liver disease score in the first 3 weeks after liver transplantation as a predictor for long-term outcome
Autor: | Boeyuekkishi Agayev, Lorenz Frey, Alexander L. Gerbes, Martin K. Angele, Andrej Khandoga, Markus Guba, Emil Iskandarov, Jens Werner, Karl-Walter Jauch |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Primary Graft Dysfunction Kaplan-Meier Estimate 030230 surgery Liver transplantation Risk Assessment Gastroenterology End Stage Liver Disease 03 medical and health sciences Liver disease 0302 clinical medicine Model for End-Stage Liver Disease Predictive Value of Tests Risk Factors Germany Internal medicine medicine Humans Survival rate Aged Proportional Hazards Models Retrospective Studies Chi-Square Distribution Hepatology Proportional hazards model business.industry Graft Survival Middle Aged medicine.disease Liver Transplantation body regions Transplantation Treatment Outcome ROC Curve Area Under Curve Predictive value of tests Multivariate Analysis Female 030211 gastroenterology & hepatology business |
Zdroj: | European Journal of Gastroenterology & Hepatology. 28:153-158 |
ISSN: | 0954-691X |
Popis: | BackgroundEarly allograft dysfunction after liver transplantation (LTX) is not well defined. The aim of this study was to evaluate the value of early post-transplant model for end-stage liver disease (MELD) scores for predicting long-term outcome after transplantation.MethodsIn this single-center retrospective study, 362 consecutive patients after LTX were included. MELD scores at 7, 14, and 21 postoperative days (PODs) were calculated from primary lab values. Receiver operating characteristic (ROC) analyses were carried out to determine the critical cutoff MELD scores for patient and graft survival.ResultsOne year after transplantation, the patient and graft survival rates were 85 and 69%, respectively. Although pretransplant MELD scores were similar, they were significantly different at POD7, POD14, and POD21 between patients who died and those who survived the first year after transplantation. As shown by ROC curves, for patient survival, the optimal time point is POD14 with a cutoff MELD of 17. At this time point, patients with a MELD below 17 showed a 1-year survival rate of 94.3% and patients with a MELD of 17 and higher showed a 1-year survival rate of only 75.4%. For graft survival, the optimal time point was day 7 and a cutoff MELD of 29 (92% at MELD |
Databáze: | OpenAIRE |
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