Comparison of Liver Transplant Outcomes for Recipients With MELD <35 Vs. >35
Div. of Transplantation, Department of Surgery, University of Minnesota, Mpls, MN.
Meeting: 2015 American Transplant Congress
Abstract number: C123
Keywords: High-risk, Liver transplantation, Outcome
Session Information
Session Name: Poster Session C: Liver Donation and Allocation
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Introduction: Current allocation favors liver recipients with MELD > 35 . We compared liver tx outcomes among two groups based on MELD score at the time of tx (<35 vs >35).
Methods: Between 5/2009 and 4/2014, 271 recipients (158 MELD <35; 113 MELD>35) underwent DD liver tx with mean follow-up of 3 yrs (0.5 – 5). Demographics are shown in Table 1.
| MELD<35 (n=158) | MELD>35 (n=113) | |
| Mean Recipient Age | 57 yo (20-71) | 56 yo (21-70) |
| Mean MELD at Tx | 30 (14-34) | 40 (35-55) |
| Causes of Liver Failure | ||
| ETOH Cirrhosis | 30% (47) | 25% (28) |
| HCC | 22% (36) | 4% (4) |
| Hep B/C Cirrhosis | 17% (27) | 27% (30) |
| Acute Hepatic Necrosis | 4% (6) | 11% (13) |
| Other | 27% (42) | 34% (38) |
| Hospitalized Pts | 17% (27) | 38% (43) |
| ICU Hospitalized Pts | 10% (16) | 38% (43) |
| Pre-Tx Hemodialysis | 11% (17) | 53% (60) |
| SLiK | 11% (18) | 13% (15) |
| Re-transplant | 3% (5) | 11% (13) |
| Mean Donor Age | 43 yo (13-79) | 43 yo (15-78) |
| DCD Donor | 8% (13) | 5% (6) |
| Mean Organ Cold Ischemia Time | 6 hrs (1.5-14.5) | 6 hrs (1-11) |
Results: Actuarial PS is shown in Figure 1.
GS was 92% for MELD<35 recipients and 95% for MELD>35 at 1 yr. Major causes of death for recipients with MELD <35 were infection 31%, liver failure 19%, malignancy 17% and for recipients with MELD > 35, were infection 30% and CVD 15%. Causes of graft loss for both groups included: rejection, primary non-function; in addition MELD<35 group lost 3 grafts to HA and portal vein thrombosis. Table 2 compares intra- and post-op outcomes between two groups.
| MELD<35 | MELD>35 | |
| Average EBL | 1.7 L (0.2-15L) | 3.5 L (0.3-25L) |
| Length of Stay | 16 days (3-90d) | 33 days (1-59d) |
| Length of Stay in ICU | 6 days (0-57d) | 11 days (0-116d) |
| % of Re-exploration (n) | 19% (30) | 31% (34) |
| Post-Tx Hemodialysis | 20% (32) | 26% (29) |
| Thrombosis | 9% (14) | 7% (8) |
| Bile Leak/Biloma | 8% (13) | 7% (8) |
Conclusion: There was no difference in PS for recipients in two groups. MELD [gr]35 associated with complicated and prolonged post-operative course; however, there was no difference in technical complications between two groups.
To cite this abstract in AMA style:
Kirchner V, Chinnakotla S, Kandaswamy R, Payne W, Pruett T. Comparison of Liver Transplant Outcomes for Recipients With MELD <35 Vs. >35 [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-liver-transplant-outcomes-for-recipients-with-meld-35-vs-35/. Accessed November 24, 2024.« Back to 2015 American Transplant Congress