Kim D J, Lee S-K, Jo J W, Kim S J, Kwon C H D, Park J W, Han Y S, Park J B
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, Korea 135-710.
Transplant Proc. 2006 Sep;38(7):2095-6. doi: 10.1016/j.transproceed.2006.06.031.
The model for end-stage liver disease (MELD) has been an excellent predictor of 3-month mortality among cirrhotic patients awaiting orthotopic liver transplantation (OLT). The aim of this study was to evaluate whether the preoperative MELD score predicts short-term prognosis after OLT. We enrolled 98 adult liver transplant patients performed at our center from January 2001 to December 2002. In univariate analysis of risk factors for death within 3 and 6 months after liver transplantation, serum total bilirubin, creatinine, MELD score, hyponatremia with ascites, Child-Turcotte-Pugh (CTP) score were statistically significant parameters (P < .05). By logistic regression, none of the risk factors were subjected to multivariate analysis showed statistical significance. The odds ratios of the MELD score, hyponatremia with ascites, CTP score within 3 months were 0.997, 1.151, and 0.726 with 95% confidence intervals of [0.899, 1.105], [0.102, 12.959], and [0.389, 1.352], respectively. The odds ratio of MELD score, hyponatremia with ascites, CTP score within 6 months were 0.996, 0.914, and 0.764, with 95% confidence intervals of [0.901, 1.102], [0.089, 9.369], and [0.417, 1.401], respectively. Although MELD score has been a good predictor of short-term prognosis before OLT, MELD did not show an influence on the short-term prognosis after liver transplantation in this study.
终末期肝病模型(MELD)一直是等待原位肝移植(OLT)的肝硬化患者3个月死亡率的出色预测指标。本研究的目的是评估术前MELD评分是否能预测OLT后的短期预后。我们纳入了2001年1月至2002年12月在本中心进行的98例成人肝移植患者。在对肝移植后3个月和6个月内死亡危险因素的单因素分析中,血清总胆红素、肌酐、MELD评分、伴有腹水的低钠血症、Child-Turcotte-Pugh(CTP)评分是具有统计学意义的参数(P < 0.05)。通过逻辑回归分析,多因素分析中显示的危险因素均未表现出统计学意义。MELD评分、伴有腹水的低钠血症、3个月内CTP评分的比值比分别为0.997、1.151和0.726,95%置信区间分别为[0.899, 1.105]、[0.102, 12.959]和[0.389, 1.352]。MELD评分、伴有腹水的低钠血症、6个月内CTP评分的比值比分别为0.996、0.914和0.764,95%置信区间分别为[0.901, 1.102]、[0.089, 9.369]和[0.417, 1.401]。尽管MELD评分一直是OLT前短期预后的良好预测指标,但在本研究中MELD评分对肝移植后的短期预后未显示出影响。