ArticleCanadian journal of gastroenterology & hepatology2015
Postoperative resource utilization and survival among liver transplant recipients with Model for End-stage Liver Disease score ≥ 40: A retrospective cohort study.
Article in Canadian journal of gastroenterology & hepatology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Referral to Liver Transplant: A National Survey from Portugal.GE Portuguese journal of gastroenterology · 2025Article
- The effects of prognostic factors on transplant and mortality of patients with end-stage liver disease using Markov multistate model.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2023Article
- Approaches for patients with very high MELD scores.JHEP reports : innovation in hepatology · 2019Review
- [Frontiers in liver transplantation in indication and techniques].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2019Review
- Single-Center Experience on Liver Transplantation for Model for End-Stage Liver Disease Score 40 Patients.Digestive diseases and sciences · 2016Article
- Pretransplant Factors and Associations with Postoperative Respiratory Failure, ICU Length of Stay, and Short-Term Survival after Liver Transplantation in a High MELD Population.Journal of transplantation · 2016Article
- The Perme scale score as a predictor of functional status and complications after discharge from the intensive care unit in patients undergoing liver transplantation.Revista Brasileira de terapia intensivaObservational
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6 authors.
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Abstract
backgroundCirrhotic patients with Model for End-stage Liver Disease (MELD) score ≥ 40 have high risk for death without liver transplant (LT).
objectiveTo evaluate these patients' outcomes after LT.
methodsThe present study analyzed a retrospective cohort of 519 cirrhotic adult patients who underwent LT at a single Canadian centre between 2002 and 2012. Primary exposure was severity of liver disease measured by MELD score at LT (≥ 40 versus < 40). Primary outcome was duration of first intensive care unit (ICU) stay after LT. Secondary outcomes were duration of first hospital stay after LT, rate of ICU readmission, re-LT and survival rates.
resultsOn the day of LT, 5% (28 of 519) of patients had a MELD score ≥ 40. These patients had longer first ICU stays after LT (14 versus two days; P < 0.001). MELD score ≥ 40 at LT was independently associated with first ICU stay after LT ≥ 10 days (OR 3.21). These patients had longer first hospital stays after LT (45 versus 18 days; P < 0.001); however, there was no significant difference in the rate of ICU readmission (18% versus 22%; P = 0.58) or re-LT rate (4% versus 4%; P = 1.00). Cumulative survival at one month, three months, one year, three years and five years was 98%, 96%, 90%, 79% and 72%, respectively. There was no significant difference in cumulative survival stratified according to MELD score ≥ 40 versus < 40 at LT (P = 0.59).
conclusionsCirrhotic patients with MELD score ≥ 40 at LT utilize greater postoperative health resources; however, they derive similar long-term survival benefit from LT.
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