Product of Donor Age and Preoperative MELD, D−MELD, Predicts Surgical Outcomes after LDLT in HCV Positive Recipients, but Not in HCV Negative Recipients, The
Hepatobiliary-Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Japan
Meeting: 2013 American Transplant Congress
Abstract number: D1620
Background:
Donor age and MELD score are recognized as risk factors affecting recipient outcomes in living donor liver transplantation (LDLT). The aim of this study is to evaluate whether D-MELD (donor age × recipient MELD) score can predict the recipient outcomes in LDLT, paying the special attention to the underlying liver diseases of the recipients.
Patients and Methods:
The 109 consecutive cases, who underwent LDLT from March 2002 to September 2012, were divided into the three groups according to D-MELD score: Group A (n=19): D-MELD<330, Group B (n=73): 330≤ D-MELD <1000, Group C (n=17): D-MELD ≥1000. Among those cases, HCV positive (n=41) or negative recipients (n=68) were also divided into the three groups: Group A (n=11), Group B (n=25), Group C (n=5) in HCV positive recipients, and Group A (n=8), Group B (n=48), Group C (n=12) in HCV negative recipients.
Results:
All recipients: The 90-day mortality rates were 5.3%, 15.1% and 35.3% in Groups A, B and C, respectively (p=0.045). There were no significant differences in the survival rates among three groups. Although total rate of complications did not differ, the rate of vascular complication was significantly higher in the groups with higher D-MELD score: 0%, 8.3% and 29.4% in Groups A, B and C, respectively (p=0.009).
HCV positive recipients: The 90-day mortality rates were 9.1%, 12% and 80% in Groups A, B and C, respectively (p=0.0013). Recipient survival rates significantly decreased as D-MELD score increased: 3-year survival rate was 72.7%, 53.2% and 20.0% in Groups A, B and C, respectively (p=0.002). The rate of vascular complication was significantly higher in the groups with higher D-MELD score: 0%, 8.0% and 60.0% in Groups A, B and C, respectively (p=0.002).
HCV negative recipients: There were no significant differences in survival rate, 90-day mortality rate and the rates of complications among the three groups.
When the recipients were divided into the groups by only donor age 50 or MELD score 20, the survival rates did not differ between the groups.
Conclusions:
In LDLT, D-MELD affected the short and long term survival and the rate of vascular complication in HCV positive recipients, but not in HCV negative recipients. D-MELD score seems to be useful only in HCV positive recipients in LDLT.
To cite this abstract in AMA style:
Tanemura A, Mizuno S, Kuriyama N, Azumi Y, Osawa I, Kishiwada M, Usui M, Sakurai H, Tabata M, Isaji S. Product of Donor Age and Preoperative MELD, D−MELD, Predicts Surgical Outcomes after LDLT in HCV Positive Recipients, but Not in HCV Negative Recipients, The [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/product-of-donor-age-and-preoperative-meld-dmeld-predicts-surgical-outcomes-after-ldlt-in-hcv-positive-recipients-but-not-in-hcv-negative-recipients-the/. Accessed May 17, 2025.« Back to 2013 American Transplant Congress