Emiroglu R, Yilmaz U, Coskun M, Karakayali H, Haberal M
Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey.
Transplant Proc. 2007 May;39(4):1164-5. doi: 10.1016/j.transproceed.2007.02.048.
The aim of this study was to determine whether scores from the model for end-stage liver disease (MELD) can be used in the preoperative strategic planning of transplantation surgery. We retrospectively analyzed the outcomes of 62 adult liver transplantation patients whose operation was performed at our center between January 2001 and June 2006. All patients had MELD scores between 8 and 35 with an average value of 20. We compared postoperative mortality among patients who had MELD scores higher than 20 as determined by their graft-to-host ratios. We separately grouped the patients whose graft-to-body weight ratio (GBWR) was equal to or lower than 1 and whose GBWR was higher than 1. The GBWRs associated with mortality after living-donor liver transplantation in the early postoperative period were considered significant (P=.005). MELD scores were also found to be associated with mortality (P=.006). Mortality rates in patients with high MELD scores and a low GBWR were highest among the other combinations. In conclusion, we found that GBWR lower than 1 and MELD score higher than 20 are significant risk factors for mortality after living donor liver transplantation. Patients with low MELD scores can undergo transplantation when their GBWR is lower than 1, but recipients with high MELD scores should receive grafts only when their GBWR is higher than 1.
本研究的目的是确定终末期肝病模型（MELD）评分是否可用于移植手术的术前战略规划。我们回顾性分析了2001年1月至2006年6月在本中心接受手术的62例成人肝移植患者的预后。所有患者的MELD评分在8至35之间，平均值为20。我们根据移植物与宿主的比例比较了MELD评分高于20的患者的术后死亡率。我们将移植物与体重比（GBWR）等于或低于1的患者和GBWR高于1的患者分别分组。术后早期活体肝移植后与死亡率相关的GBWR被认为具有统计学意义（P = 0.005）。还发现MELD评分与死亡率相关（P = 0.006）。在其他组合中，MELD评分高且GBWR低的患者死亡率最高。总之，我们发现GBWR低于1和MELD评分高于20是活体肝移植后死亡的重要危险因素。MELD评分低的患者在GBWR低于1时可以进行移植，但MELD评分高的受者只有在GBWR高于1时才能接受移植物。
