D-MELD as a predictor of early graft mortality in adult-to-adult living-donor liver transplantation

Toru Ikegami, Daisuke Imai, Huanlin Wang, Tomoharu Yoshizumi, Yo Ichi Yamashita, Mizuki Ninomiya, Tomohiro Iguchi, Yuki Bekki, Ken Shirabe, Yoshihiko Maehara

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: Ensuring 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. METHODS: We retrospectively evaluated the records of 355 adults who underwent LDLT for chronic liver disease and explored the relationship between D-MELD and graft outcome. RESULTS: High 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). CONCLUSIONS: The 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.

Original languageEnglish
Pages (from-to)457-462
Number of pages6
JournalTransplantation
Volume97
Issue number4
DOIs
Publication statusPublished - Feb 27 2014

All Science Journal Classification (ASJC) codes

  • Transplantation

Fingerprint Dive into the research topics of 'D-MELD as a predictor of early graft mortality in adult-to-adult living-donor liver transplantation'. Together they form a unique fingerprint.

  • Cite this

    Ikegami, T., Imai, D., Wang, H., Yoshizumi, T., Yamashita, Y. I., Ninomiya, M., Iguchi, T., Bekki, Y., Shirabe, K., & Maehara, Y. (2014). D-MELD as a predictor of early graft mortality in adult-to-adult living-donor liver transplantation. Transplantation, 97(4), 457-462. https://doi.org/10.1097/01.TP.0000435696.23525.d0