Costabeber Ane M, Lionço Lívia C, Marroni Cláudio, Zanotelli Maria L, Cantisani Guido, Brandão Ajácio
Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Liver Transplantation Group, Santa Casa de Misericórdia de Porto Alegre, RS, Brazil.
Ann Hepatol. 2014 Nov-Dec;13(6):781-7.
The D-MELD score was designed to prevent donor-recipient matches with a high risk of unfavorable outcome. The main objective of the present study was to assess the predictive value of the DMELD score for 1-month and 3-month post-transplant mortality in a cohort of patients who underwent deceased-donor liver transplantation in Southern Brazil.
A cohort study was conducted. Receiver operating characteristic c-statistics were used to determine the ability of the D-MELD score to predict mortality. The Kaplan-Meier method was used to analyze survival as a function of time regarding D-MELD scores, and the Cox model was employed to assess the association between D-MELD and mortality.
Most recipients were male, with a mean age of 54.3 ± 9.6 years (n = 233 transplants). Mean donor age was 44.9 ± 16.8 years (19.3% of donors were aged ≥ 60 years). Mean MELD and D-MELD scores were 16.3 ± 7.1 and 733.1 ± 437.8 respectively. Overall survival at 1 and 3 months was 83.6%. The c-statistic value for 1- and 3-month mortality was < 0.5 for the D-MELD. Analysis of Kaplan-Meier curves for groups with D-MELD scores < 1,600 and ≥ 1,600 did not show statistically significant differences in survival (p = 0.722).
D-MELD scores were unable to predict survival in this cohort of Brazilian liver transplant recipients.
D-MELD评分旨在避免供体-受体配对出现不良结局风险较高的情况。本研究的主要目的是评估D-MELD评分对巴西南部接受已故供体肝移植患者队列中1个月和3个月移植后死亡率的预测价值。
进行了一项队列研究。采用受试者工作特征曲线下面积（c统计量）来确定D-MELD评分预测死亡率的能力。采用Kaplan-Meier方法分析D-MELD评分随时间变化的生存情况，并使用Cox模型评估D-MELD与死亡率之间的关联。
大多数受者为男性，平均年龄为54.3±9.6岁（共233例移植）。供体平均年龄为44.9±16.8岁（19.3%的供体年龄≥60岁）。MELD和D-MELD评分的平均值分别为16.3±7.1和733.1±437.8。1个月和3个月时的总体生存率为83.6%。D-MELD评分对于1个月和3个月死亡率的c统计量值<0.5。对D-MELD评分<1600和≥1600的组进行Kaplan-Meier曲线分析，未显示出生存率的统计学显著差异（p=0.722）。
D-MELD评分无法预测该巴西肝移植受者队列中的生存情况。
