A high MELD score, combined with the presence of hepatitis C, is associated with a poor prognosis in living donor liver transplantation

Toru Ikegami, Ken Shirabe, Shohei Yoshiya, Tomoharu Yoshizumi, Yo Ichi Yamashita, Norifumi Harimoto, Takeo Toshima, Hideaki Uchiyama, Yuji Soejima, Yoshihiko Maehara

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Abstract

Purpose: The feasibility of performing living donor liver transplantation (LDLT) for patients with high end-stage liver disease (MELD) scores needs to be assessed. Methods: A total of 357 patients who underwent LDLT were included in this analysis. Results: Overall, 46 patients had high MELD scores (≥25) and their graft survival was similar to that in patients with low MELD scores (<25; n = 311; p = 0.395). However, among patients with high MELD scores, a multivariate analysis showed that the presence of hepatitis C (p = 0.013) and LDLT in Era-I (p = 0.036) was significantly associated with a poorer prognosis. Among patients with hepatitis C (n = 155), the 5-year graft survival rate was significantly lower in patients with high MELD scores (33.7 %, p < 0.001) than in patients with low MELD scores. The 5-year graft survival rate was significantly lower in patients in Era-I (n = 119) compared with those in Era-II/III when stratified by low (73.0 vs. 82.5 %, p = 0.040) and high (55.0 vs. 86.1 %, p = 0.023) MELD scores. Among the patients with high MELD scores, those with hepatitis C and LDLT in Era-I had the worst 5-year graft survival rate (14.3, p < 0.001). Conclusion: The graft outcomes in patients with high MELD scores and the presence of hepatitis C were found to be particularly poor.

Original languageEnglish
Pages (from-to)233-240
Number of pages8
JournalSurgery Today
Volume44
Issue number2
DOIs
Publication statusPublished - Feb 1 2014

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Living Donors
Hepatitis C
Liver Transplantation
Graft Survival
Survival Rate
End Stage Liver Disease
Multivariate Analysis
Transplants

All Science Journal Classification (ASJC) codes

  • Surgery

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A high MELD score, combined with the presence of hepatitis C, is associated with a poor prognosis in living donor liver transplantation. / Ikegami, Toru; Shirabe, Ken; Yoshiya, Shohei; Yoshizumi, Tomoharu; Yamashita, Yo Ichi; Harimoto, Norifumi; Toshima, Takeo; Uchiyama, Hideaki; Soejima, Yuji; Maehara, Yoshihiko.

In: Surgery Today, Vol. 44, No. 2, 01.02.2014, p. 233-240.

Research output: Contribution to journalArticle

Ikegami, Toru ; Shirabe, Ken ; Yoshiya, Shohei ; Yoshizumi, Tomoharu ; Yamashita, Yo Ichi ; Harimoto, Norifumi ; Toshima, Takeo ; Uchiyama, Hideaki ; Soejima, Yuji ; Maehara, Yoshihiko. / A high MELD score, combined with the presence of hepatitis C, is associated with a poor prognosis in living donor liver transplantation. In: Surgery Today. 2014 ; Vol. 44, No. 2. pp. 233-240.
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abstract = "Purpose: The feasibility of performing living donor liver transplantation (LDLT) for patients with high end-stage liver disease (MELD) scores needs to be assessed. Methods: A total of 357 patients who underwent LDLT were included in this analysis. Results: Overall, 46 patients had high MELD scores (≥25) and their graft survival was similar to that in patients with low MELD scores (<25; n = 311; p = 0.395). However, among patients with high MELD scores, a multivariate analysis showed that the presence of hepatitis C (p = 0.013) and LDLT in Era-I (p = 0.036) was significantly associated with a poorer prognosis. Among patients with hepatitis C (n = 155), the 5-year graft survival rate was significantly lower in patients with high MELD scores (33.7 {\%}, p < 0.001) than in patients with low MELD scores. The 5-year graft survival rate was significantly lower in patients in Era-I (n = 119) compared with those in Era-II/III when stratified by low (73.0 vs. 82.5 {\%}, p = 0.040) and high (55.0 vs. 86.1 {\%}, p = 0.023) MELD scores. Among the patients with high MELD scores, those with hepatitis C and LDLT in Era-I had the worst 5-year graft survival rate (14.3, p < 0.001). Conclusion: The graft outcomes in patients with high MELD scores and the presence of hepatitis C were found to be particularly poor.",
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AU - Shirabe, Ken

AU - Yoshiya, Shohei

AU - Yoshizumi, Tomoharu

AU - Yamashita, Yo Ichi

AU - Harimoto, Norifumi

AU - Toshima, Takeo

AU - Uchiyama, Hideaki

AU - Soejima, Yuji

AU - Maehara, Yoshihiko

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N2 - Purpose: The feasibility of performing living donor liver transplantation (LDLT) for patients with high end-stage liver disease (MELD) scores needs to be assessed. Methods: A total of 357 patients who underwent LDLT were included in this analysis. Results: Overall, 46 patients had high MELD scores (≥25) and their graft survival was similar to that in patients with low MELD scores (<25; n = 311; p = 0.395). However, among patients with high MELD scores, a multivariate analysis showed that the presence of hepatitis C (p = 0.013) and LDLT in Era-I (p = 0.036) was significantly associated with a poorer prognosis. Among patients with hepatitis C (n = 155), the 5-year graft survival rate was significantly lower in patients with high MELD scores (33.7 %, p < 0.001) than in patients with low MELD scores. The 5-year graft survival rate was significantly lower in patients in Era-I (n = 119) compared with those in Era-II/III when stratified by low (73.0 vs. 82.5 %, p = 0.040) and high (55.0 vs. 86.1 %, p = 0.023) MELD scores. Among the patients with high MELD scores, those with hepatitis C and LDLT in Era-I had the worst 5-year graft survival rate (14.3, p < 0.001). Conclusion: The graft outcomes in patients with high MELD scores and the presence of hepatitis C were found to be particularly poor.

AB - Purpose: The feasibility of performing living donor liver transplantation (LDLT) for patients with high end-stage liver disease (MELD) scores needs to be assessed. Methods: A total of 357 patients who underwent LDLT were included in this analysis. Results: Overall, 46 patients had high MELD scores (≥25) and their graft survival was similar to that in patients with low MELD scores (<25; n = 311; p = 0.395). However, among patients with high MELD scores, a multivariate analysis showed that the presence of hepatitis C (p = 0.013) and LDLT in Era-I (p = 0.036) was significantly associated with a poorer prognosis. Among patients with hepatitis C (n = 155), the 5-year graft survival rate was significantly lower in patients with high MELD scores (33.7 %, p < 0.001) than in patients with low MELD scores. The 5-year graft survival rate was significantly lower in patients in Era-I (n = 119) compared with those in Era-II/III when stratified by low (73.0 vs. 82.5 %, p = 0.040) and high (55.0 vs. 86.1 %, p = 0.023) MELD scores. Among the patients with high MELD scores, those with hepatitis C and LDLT in Era-I had the worst 5-year graft survival rate (14.3, p < 0.001). Conclusion: The graft outcomes in patients with high MELD scores and the presence of hepatitis C were found to be particularly poor.

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