D-MELD does not predict post-liver transplantation survival: a single-center experience from Brazil

• Published in: Annals of hepatology Vol. 13; no. 6; pp. 781 - 787
• Main Authors: Costabeber, Ane M, Lionço, Lívia C, Marroni, Cláudio, Zanotelli, Maria L, Cantisani, Guido, Brandão, Ajácio, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: Mexico Elsevier 01.11.2014
• Subjects: Adult; Brazil; Cohort Studies; End Stage Liver Disease - surgery; Female; Gastroenterology and Hepatology; Humans; Kaplan-Meier Estimate; Liver transplant; Liver Transplantation; Male; Middle Aged; Outcome; Prognosis; Prognostic models; Proportional Hazards Models; Retrospective Studies; ROC Curve; Severity of Illness Index; Survival Rate; Brazil; Liver transplant; Prognostic models; Outcome
• ISSN: 1665-2681; 2659-5982
• DOI: 10.1016/S1665-2681(19)30980-9

AbstractBackground. 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 D-MELD 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.