Impact of MELD on short-term and long-term outcome following liver transplantation: a European perspective

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Abstract
The Model for End-Stage Liver Disease (MELD) has been found to accurately predict pre-transplant mortality and is a valuable system for ranking patients in need of liver transplantation. Its association with post-transplant outcome, however, remains unclear. We retrospectively studied 121 adult patients who were transplanted for non-fulminant liver failure between January 1991 and December 2001. MELD scores were calculated taking variables as close as possible prior to liver transplantation. Patients were stratified into two or three groups using different cut-off values of the MELD score. Indications for liver transplantation were mainly alcoholic liver disease (47.1%) or hepatitis C virus (19.0%). Gender distribution was male 62% vs female 38%. Mean age was 54 years±10 years. Mean MELD score was 16±6. Follow-up time was 5.4 years (range, 1.6–12.3 years). The use of different MELD cut-off levels yielded no difference in survival at different time points. Higher MELD scores did not have a negative impact on patient and graft survival following OLT. Since MELD is good at identifying those urgently in need of liver transplantation and high MELD scores do not appear to have an influence on long-term outcome, use of MELD in liver allocation seems warranted.