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Use of Post-Transplant MELD Score to Predict Graft Loss After a Living Donor Liver Transplant

Description

Toshima et al used the post-operative MELD score to identify a liver transplant patient who is at risk for graft loss. This can help to identify a patient who may benefit from more aggressive management. The authors are from Kyushu University in Fukoaka, Japan.


A MELD score on post-operative day (POD) 2 >= 19 was associated with short-term graft loss (odds ratio 5.6). The area under the ROC curve was 0.78.

 

Subsequent MELD scores also were predictive of graft loss:

(1) MELD on POD 7 >= 17.0 was 100% sensitive and 75% specific (NPV 100%)

(2) MELD on POD 14>= 18.5 was 90% sensitive and 86% specific (NPV 99%)

 

If the patient was hospitalized prior to the transplant then the odds ratio for graft loss was 3.3.


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