D-MELD as a Predictor of Early Graft Mortality in Adult-to-Adult Living-Donor Liver Transplantation

D-MELD as a Predictor of Early Graft Mortality in Adult-to-Adult Living-Donor Liver Transplantation

BACKGROUNDEnsuring a good match between donor and recipient is critically important to achieve acceptable graft outcomes after living-donor liver transplantation (LDLT). Our objective was to evaluate the product of donor age and Model for End-stage Liver Disease score (D-MELD) as a predictor of graf...

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Veröffentlicht in:Transplantation 2014-02, Vol.97 (4), p.457-462
Hauptverfasser: Ikegami, Toru, Imai, Daisuke, Wang, Huanlin, Yoshizumi, Tomoharu, Yamashita, Yo-ichi, Ninomiya, Mizuki, Iguchi, Tomohiro, Bekki, Yuki, Shirabe, Ken, Maehara, Yoshihiko
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container_end_page 462
container_issue 4
container_start_page 457
container_title Transplantation
container_volume 97
creator Ikegami, Toru
Imai, Daisuke
Wang, Huanlin
Yoshizumi, Tomoharu
Yamashita, Yo-ichi
Ninomiya, Mizuki
Iguchi, Tomohiro
Bekki, Yuki
Shirabe, Ken
Maehara, Yoshihiko
description BACKGROUNDEnsuring a good match between donor and recipient is critically important to achieve acceptable graft outcomes after living-donor liver transplantation (LDLT). Our objective was to evaluate the product of donor age and Model for End-stage Liver Disease score (D-MELD) as a predictor of graft survival after LDLT. METHODSWe retrospectively evaluated the records of 355 adults who underwent LDLT for chronic liver disease and explored the relationship between D-MELD and graft outcome. RESULTSHigh MELD score and advanced donor age were significantly associated with graft survival; D-MELD had the strongest association with in-hospital mortality. Receiver operating characteristic curve analysis showed that a D-MELD score of 462 had the highest sensitivity for predicting in-hospital mortality. Patients were allocated to three groups based on D-MELD (Class A [≤449; n=142], Class B [450–899; n=163], and Class C [≥900; n=50]) and were found to have stratified cumulative 2-year graft survivals of 94.1%, 85.3%, and 63.1%, respectively (P
doi_str_mv 10.1097/01.TP.0000435696.23525.d0
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Our objective was to evaluate the product of donor age and Model for End-stage Liver Disease score (D-MELD) as a predictor of graft survival after LDLT. METHODSWe retrospectively evaluated the records of 355 adults who underwent LDLT for chronic liver disease and explored the relationship between D-MELD and graft outcome. RESULTSHigh MELD score and advanced donor age were significantly associated with graft survival; D-MELD had the strongest association with in-hospital mortality. Receiver operating characteristic curve analysis showed that a D-MELD score of 462 had the highest sensitivity for predicting in-hospital mortality. Patients were allocated to three groups based on D-MELD (Class A [≤449; n=142], Class B [450–899; n=163], and Class C [≥900; n=50]) and were found to have stratified cumulative 2-year graft survivals of 94.1%, 85.3%, and 63.1%, respectively (P<0.01). Although D-MELD Class C patients had larger graft volume-to-standard liver volume ratio (P<0.01) and received right lobe grafts more often (P<0.01), they still exhibited significantly higher rates of primary graft dysfunction (P<0.01) and in-hospital mortality (P<0.01). Outcomes in D-MELD Class C were significantly worse in hepatitis C–positive patients (P<0.05). CONCLUSIONSThe D-MELD score is a simple and reliable predictor of early graft survival that assists the matching of donors and recipients in LDLT in adults.]]></description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/01.TP.0000435696.23525.d0</identifier><identifier>PMID: 24162252</identifier><language>eng</language><publisher>United States: by Lippincott Williams &amp; Wilkins</publisher><ispartof>Transplantation, 2014-02, Vol.97 (4), p.457-462</ispartof><rights>2014 by Lippincott Williams &amp; Wilkins</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5206-21653b639acfafa19c2783a82a1e8d434bb6790031e18f8c996af3e9532795733</citedby><cites>FETCH-LOGICAL-c5206-21653b639acfafa19c2783a82a1e8d434bb6790031e18f8c996af3e9532795733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24162252$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ikegami, Toru</creatorcontrib><creatorcontrib>Imai, Daisuke</creatorcontrib><creatorcontrib>Wang, Huanlin</creatorcontrib><creatorcontrib>Yoshizumi, Tomoharu</creatorcontrib><creatorcontrib>Yamashita, Yo-ichi</creatorcontrib><creatorcontrib>Ninomiya, Mizuki</creatorcontrib><creatorcontrib>Iguchi, Tomohiro</creatorcontrib><creatorcontrib>Bekki, Yuki</creatorcontrib><creatorcontrib>Shirabe, Ken</creatorcontrib><creatorcontrib>Maehara, Yoshihiko</creatorcontrib><title>D-MELD as a Predictor of Early Graft Mortality in Adult-to-Adult Living-Donor Liver Transplantation</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description><![CDATA[BACKGROUNDEnsuring a good match between donor and recipient is critically important to achieve acceptable graft outcomes after living-donor liver transplantation (LDLT). Our objective was to evaluate the product of donor age and Model for End-stage Liver Disease score (D-MELD) as a predictor of graft survival after LDLT. METHODSWe retrospectively evaluated the records of 355 adults who underwent LDLT for chronic liver disease and explored the relationship between D-MELD and graft outcome. RESULTSHigh MELD score and advanced donor age were significantly associated with graft survival; D-MELD had the strongest association with in-hospital mortality. Receiver operating characteristic curve analysis showed that a D-MELD score of 462 had the highest sensitivity for predicting in-hospital mortality. Patients were allocated to three groups based on D-MELD (Class A [≤449; n=142], Class B [450–899; n=163], and Class C [≥900; n=50]) and were found to have stratified cumulative 2-year graft survivals of 94.1%, 85.3%, and 63.1%, respectively (P<0.01). Although D-MELD Class C patients had larger graft volume-to-standard liver volume ratio (P<0.01) and received right lobe grafts more often (P<0.01), they still exhibited significantly higher rates of primary graft dysfunction (P<0.01) and in-hospital mortality (P<0.01). Outcomes in D-MELD Class C were significantly worse in hepatitis C–positive patients (P<0.05). CONCLUSIONSThe D-MELD score is a simple and reliable predictor of early graft survival that assists the matching of donors and recipients in LDLT in adults.]]></description><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNpFkEFTGyEUx5lOnZrafgUHb72w5cECy9Ex0XYmjjmkZ4bssnWVLBFYnXx7MdGWy4PH7_9gfghdAK2AavWTQrVeVbSsmgupZcW4YKLq6Cc0A8FrImlDP6NZuQcCnKtT9DWlh8ILrtQXdMpqkIwJNkPtnNwulnNsE7Z4FV03tDlEHHq8sNHv8U20fca3IWbrh7zHw4gvu8lnkgM5bPByeB7Gv2QexpIrBxfxOtox7bwds81DGL-hk9765L6_1zP053qxvvpFlnc3v68ul6QVjErCQAq-kVzbtre9Bd0y1XDbMAuu6WpebzZSaUo5OGj6ptVa2p47LThTWijOz9CP49xdDE-TS9lsh9Q6Xz7iwpQM1FoXPQBNQfURbWNIKbre7OKwtXFvgJo3x4aCWa_Mf8fm4Nh0tGTP35-ZNlvX_Ut-SC1AfQRegs8upkc_vbho7p31-f4wUjWaEkahpowpSkoHJH8FMJ-F9w</recordid><startdate>20140227</startdate><enddate>20140227</enddate><creator>Ikegami, Toru</creator><creator>Imai, Daisuke</creator><creator>Wang, Huanlin</creator><creator>Yoshizumi, Tomoharu</creator><creator>Yamashita, Yo-ichi</creator><creator>Ninomiya, Mizuki</creator><creator>Iguchi, Tomohiro</creator><creator>Bekki, Yuki</creator><creator>Shirabe, Ken</creator><creator>Maehara, Yoshihiko</creator><general>by Lippincott Williams &amp; Wilkins</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140227</creationdate><title>D-MELD as a Predictor of Early Graft Mortality in Adult-to-Adult Living-Donor Liver Transplantation</title><author>Ikegami, Toru ; Imai, Daisuke ; Wang, Huanlin ; Yoshizumi, Tomoharu ; Yamashita, Yo-ichi ; Ninomiya, Mizuki ; Iguchi, Tomohiro ; Bekki, Yuki ; Shirabe, Ken ; Maehara, Yoshihiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5206-21653b639acfafa19c2783a82a1e8d434bb6790031e18f8c996af3e9532795733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ikegami, Toru</creatorcontrib><creatorcontrib>Imai, Daisuke</creatorcontrib><creatorcontrib>Wang, Huanlin</creatorcontrib><creatorcontrib>Yoshizumi, Tomoharu</creatorcontrib><creatorcontrib>Yamashita, Yo-ichi</creatorcontrib><creatorcontrib>Ninomiya, Mizuki</creatorcontrib><creatorcontrib>Iguchi, Tomohiro</creatorcontrib><creatorcontrib>Bekki, Yuki</creatorcontrib><creatorcontrib>Shirabe, Ken</creatorcontrib><creatorcontrib>Maehara, Yoshihiko</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ikegami, Toru</au><au>Imai, Daisuke</au><au>Wang, Huanlin</au><au>Yoshizumi, Tomoharu</au><au>Yamashita, Yo-ichi</au><au>Ninomiya, Mizuki</au><au>Iguchi, Tomohiro</au><au>Bekki, Yuki</au><au>Shirabe, Ken</au><au>Maehara, Yoshihiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>D-MELD as a Predictor of Early Graft Mortality in Adult-to-Adult Living-Donor Liver Transplantation</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2014-02-27</date><risdate>2014</risdate><volume>97</volume><issue>4</issue><spage>457</spage><epage>462</epage><pages>457-462</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><abstract><![CDATA[BACKGROUNDEnsuring a good match between donor and recipient is critically important to achieve acceptable graft outcomes after living-donor liver transplantation (LDLT). Our objective was to evaluate the product of donor age and Model for End-stage Liver Disease score (D-MELD) as a predictor of graft survival after LDLT. METHODSWe retrospectively evaluated the records of 355 adults who underwent LDLT for chronic liver disease and explored the relationship between D-MELD and graft outcome. RESULTSHigh MELD score and advanced donor age were significantly associated with graft survival; D-MELD had the strongest association with in-hospital mortality. Receiver operating characteristic curve analysis showed that a D-MELD score of 462 had the highest sensitivity for predicting in-hospital mortality. Patients were allocated to three groups based on D-MELD (Class A [≤449; n=142], Class B [450–899; n=163], and Class C [≥900; n=50]) and were found to have stratified cumulative 2-year graft survivals of 94.1%, 85.3%, and 63.1%, respectively (P<0.01). Although D-MELD Class C patients had larger graft volume-to-standard liver volume ratio (P<0.01) and received right lobe grafts more often (P<0.01), they still exhibited significantly higher rates of primary graft dysfunction (P<0.01) and in-hospital mortality (P<0.01). Outcomes in D-MELD Class C were significantly worse in hepatitis C–positive patients (P<0.05). CONCLUSIONSThe D-MELD score is a simple and reliable predictor of early graft survival that assists the matching of donors and recipients in LDLT in adults.]]></abstract><cop>United States</cop><pub>by Lippincott Williams &amp; Wilkins</pub><pmid>24162252</pmid><doi>10.1097/01.TP.0000435696.23525.d0</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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