D-MELD does not predict post-liver transplantation survival:

A single-center experience from Brazil 

Autores: Marroni Cláudio Augusto, Costabeber Ane Micheli, Zanotelli Maria Lúcia, Cantisani Guido, Lionço Lívia, Brandão Ajácio

Resumen

Background: The D-MELD score was designed to prevent donor-recipient matches with a high risk of unfavorable outcome. The main objective of the present study was to assess the predictive value of the DMELD score for 1-month and 3-month post-transplant mortality in a cohort of patients who underwent deceased-donor liver transplantation in Southern Brazil. Material and methods: A cohort study was conducted. Receiver operating characteristic c-statistics were used to determine the ability of the D-MELD score to predict mortality. The Kaplan-Meier method was used to analyze survival as a function of time regarding D-MELD scores, and the Cox model was employed to assess the association between D-MELD and mortality. Results: Most recipients were male, with a mean age of 54.3 ± 9.6 years (n = 233 transplants). Mean donor age was 44.9 ± 16.8 years (19.3% of donors were aged ≥ 60 years). Mean MELD and D-MELD scores were 16.3 ± 7.1 and 733.1 ± 437.8 respectively. Overall survival at 1 and 3 months was 83.6%. The c-statistic value for 1- and 3-month mortality was < 0.5 for the D-MELD. Analysis of Kaplan-Meier curves for groups with D-MELD scores < 1,600 and ≥ 1,600 did not show statistically significant differences in survival (p = 0.722). Conclusion: D-MELD scores were unable to predict survival in this cohort of Brazilian liver transplant recipients.

Palabras clave: Prognostic models liver transplant outcome.

2014-10-30   |   356 visitas   |   Evalua este artículo 0 valoraciones

Vol. 13 Núm.6. Noviembre-Diciembre 2014 Pags. 781-787 Ann Hepatol 2014; 13(6)