Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation

Autor: BRAINNER CAMPOS BARBOSA, LEANDRO AUGUSTO RODRIGUES SANTOS, GUSTAVO HENRIQUE RASSI MAHAMED DAHER, DANIEL LAHAN MARTINS, SIMONE REGES PERALES, STEPHANIS KILARIS GALLANI, LARISSA BASTOS ELOY DA COSTA, EDUARDO ANDREAZZA DAL LAGO, IIKA DE FÁTIMA SANTANTA FERREIRA BOIN, NELSON MARCIO GOMES CASERTA, ELAINE CRISTINA DE ATAÍDE
Jazyk: English<br />Spanish; Castilian<br />Portuguese
Rok vydání: 2021
Předmět:
Zdroj: Revista do Colégio Brasileiro de Cirurgiões, Vol 48 (2021)
Druh dokumentu: article
ISSN: 1809-4546
0100-6991
DOI: 10.1590/0100-6991e-20212997
Popis: ABSTRACT Objective: to correlate clinical and epidemiological data with the pathological analysis of liver explants from patients undergoing liver transplantation for hetapocarcinoma in the UNICAMP HC and to verify whether the MELD and MELD-Na scores are reliable factors to predict a worse post-transplant prognosis. Methods: we studied liver transplants carried out between May 2010 and November 2017. After excluding 38 patients, we included 87, analyzing clinical and laboratory data for correlation with the outcome Microvascular Invasion (MVI). Subsequently, we computed the MELD and MELD-Na scores and performed a descriptive analysis of clinical and laboratory data and, finally, calculated ROC curves to assess the association between these laboratory parameters and mortality in these patients. Results: most patients were male (78.30%), with an average age of 58.53 years. Most liver diseases were caused by HCV (53.26%). We found no predictors for MVI among the laboratory parameters. The ROC curves for death identified the MELD score as the cutoff point with the highest combined sensitivity (90.91%) and specificity (37.50%), with a value of 10 points, whereas in the MELD-Na the cutoff point was 7 points, with a sensitivity of 90.91% and a specificity of 33.33%, both scores being significant. Conclusions: there were no reliable predictors of MVI between clinical, laboratory, and epidemiological variables. The MELD-Na score is more sensitive than the MELD one for predicting mortality in patients undergoing liver transplantation.
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