肝移植受者在等待名单上的死亡率：与Child-Pugh分级和终末期肝病模型（MELD）的长期比较。
Liver transplant recipients mortality on the waiting list: long-term comparison to Child-Pugh classification and MELD.
作者信息
Boin I F S F, Leonardi M I, Pinto A O, Leme R S R, Udo E, Stucchi R S B, Soares E C, Leonardi L S
机构信息
Unit of Liver Transplantation, State University of Campinas, Campinas SP, Brazil.
出版信息
Transplant Proc. 2004 May;36(4):920-2. doi: 10.1016/j.transproceed.2004.03.095.
We sought to evaluate our experience concerning the high waiting list mortality rate for orthotopic liver transplantation (OLT) using the MELD (Model for End-Stage Liver Disease), which has been shown to predict short-term survival better than Child-Turcotte-Pugh (CTP) classification. The predominant end-stage disease was cirrhosis due to hepatitis C virus (67%), patient mean age was 36.8 years, and 72.1% were men. When the patients were included on a waiting list, the MELD score was stratified into W: 0 to 10; X: 11 to 20, and Y: 21 to 40 and the CPT as A: 5 to 6, B: 7 to 9, and C: 10 to 15. It was also observed that 77.8% of patients were on the waiting list, 16.4% underwent OLT and 5.8% had been removed. The estimated survival rate after 1 year was W = 85.4%; X = 83.3%, Y = 46.8%; A = 81.3%, B = 84.2%, C = 45.9%. Child median score was 8 +/- 1.5 (5 to 15) and the MELD was 14.7 +/- 5.1 (8 to 43). The mortality rate was 20.2%. Severe patients classified as Y or C showed greater mortality than the other groups (P <.001), but no significant difference between Y and C strata. The mortality rate was the same as in previous years.
我们试图评估我们在使用终末期肝病模型（MELD）进行原位肝移植（OLT）时，关于高等待名单死亡率的经验，该模型已被证明在预测短期生存方面优于Child-Turcotte-Pugh（CTP）分级。主要的终末期疾病是丙型肝炎病毒引起的肝硬化（67%），患者平均年龄为36.8岁，72.1%为男性。当患者被列入等待名单时，MELD评分被分层为W：0至10；X：11至20，以及Y：21至40，而CTP分级为A：5至6，B：7至9，以及C：10至15。还观察到77.8%的患者在等待名单上，16.4%接受了OLT，5.8%已被移除。1年后的估计生存率为W = 85.4%；X = 83.3%，Y = 46.8%；A = 81.3%，B = 84.2%，C = 45.9%。Child中位数评分为8±1.5（5至15），MELD评分为14.7±5.1（8至43）。死亡率为20.2%。分类为Y或C的重症患者显示出比其他组更高的死亡率（P <.001），但Y和C分层之间无显著差异。死亡率与前几年相同。
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