Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 8, 2016; 8(22): 942-948
Published online Aug 8, 2016. doi: 10.4254/wjh.v8.i22.942
Living donor liver transplantation for high model for end-stage liver disease score: What have we learned?
Hany Dabbous, Mohammad Sakr, Sara Abdelhakam, Iman Montasser, Mohamed Bahaa, Hany Said, Mahmoud El-Meteini
Hany Dabbous, Mohammad Sakr, Sara Abdelhakam, Iman Montasser, Department of Tropical Medicine, Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt
Mohamed Bahaa, Hany Said, Mahmoud El-Meteini, Department of Hepatobiliary Surgery, Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt
Author contributions: Dabbous H, Sakr M, Abdelhakam S, Montasser I and El-Meteini M designed the research; Dabbous H and El-Meteini M contributed equally to the work; Dabbous H, Bahaa M, Said H and El-Meteini M performed the research; Dabbous H, Abdelhakam S, Montasser I and El-Meteini M contributed analytic tools; Dabbous H, Sakr M, Abdelhakam S, Montasser I, Bahaa M and El-Meteini M analyzed the data; Dabbous H, Abdelhakam S, Montasser I, Said H and El-Meteini M wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Research Ethics Committee of the Faculty of Medicine, Ain Shams University Institutional Review Board.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data that were obtained after each patient agreed to management by written consent.
Conflict-of-interest statement: None of the authors have any conflicts of interests and no financial disclosure.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author at saratropical@yahoo.com. The participants gave informed consent for the data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sara Abdelhakam, MD, Assistant Professor of Tropical Medicine, Department of Tropical Medicine, Ain Shams Center for Organ Transplant, Faculty of Medicine, Ain Shams University, Khalifa El-Maamon St., Abbassia, Cairo 11341, Egypt. saratropical@yahoo.com
Telephone: +20-100-1601548 Fax: +20-222-598751
Received: March 15, 2016
Peer-review started: March 18, 2016
First decision: April 19, 2016
Revised: May 12, 2016
Accepted: July 11, 2016
Article in press: July 13, 2016
Published online: August 8, 2016
Processing time: 140 Days and 23.9 Hours
Abstract

AIM: To assess the impact of model for end-stage liver disease (MELD) score on patient survival and morbidity post living donor liver transplantation (LDLT).

METHODS: A retrospective study was performed on 80 adult patients who had LDLT from 2011-2013. Nine patients were excluded and 71 patients were divided into two groups; Group 1 included 38 patients with a MELD score < 20, and Group 2 included 33 patients with a MELD score > 20. Comparison between both groups was done regarding operative time, intra-operative blood requirement, intensive care unit (ICU) and hospital stay, infection, and patient survival.

RESULTS: Eleven patients died (15.5%); 3/38 (7.9%) patients in Group 1 and 8/33 (24.2%) in Group 2 with significant difference (P = 0.02). Mean operative time, duration of hospital stay, and ICU stay were similar in both groups. Mean volume of blood transfusion and cell saver re-transfusion were 8 ± 4 units and 1668 ± 202 mL, respectively, in Group 1 in comparison to 10 ± 6 units and 1910 ± 679 mL, respectively, in Group 2 with no significant difference (P = 0.09 and 0.167, respectively). The rates of infection and systemic complications (renal, respiratory, cardiovascular and neurological complications) were similar in both groups.

CONCLUSION: A MELD score > 20 may predict mortality after LDLT.

Keywords: Living donor liver transplantation, Model for end-stage liver disease score, Morbidity, Mortality, Infection

Core tip: We assessed the impact of model for end-stage liver disease (MELD) score on patient survival and morbidity after living donor liver transplantation (LDLT). A total of 71 patients were included and divided into two groups: Group 1 had 38 patients with a MELD score < 20 and Group 2 had 33 patients with a MELD score > 20. We compared between both groups regarding operative time, intra-operative blood requirement, duration of intensive care unit and hospital stay, infection, and patient survival. We found that a MELD score > 20 could predict mortality after LDLT.