Moraes Ana Claudia Oliveira de, Fonseca-Neto Olival Cirilo Lucena da
Hospital Universitário Oswaldo Cruz, Recife, PE, Brazil.
Arq Bras Cir Dig. 2018;31(2):e1370. doi: 10.1590/0102-672020180001e1370. Epub 2018 Jul 2.
Heart transplantation is still the best therapeutic alternative for the treatment of end-stage heart failure. The use of criteria that consider the complications associated with this procedure can guarantee a better evaluation of the recipient and prepare the team for possible unsatisfactory post-transplant results. The use of the MELD score has been expanded to evaluate cirrhotic patients undergoing various procedures, including cardiac transplantation.
To analyze the knowledge on MELD score and its derivatives to the prognosis of patients with end-stage heart failure considered for heart transplantation.
Was carried out an integrative review of the publications of the last ten years in Pubmed and Lilacs databases, using the descriptors "heart transplantation", "liver disease" and "prognosis". From the total of 111 articles found, six were selected and composed the sample.
The MELD-XI score (eXcluding INR) was the most analyzed in the studies due to the exclusion of INR, since many patients with heart failure use anticoagulants, which may alter their value. MELD and derivatives were associated with unsatisfactory results in cardiac transplantation.
The MELD score can be considered as a good predictor for heart transplantation; however, there are still few studies that make this correlation.
心脏移植仍然是治疗终末期心力衰竭的最佳治疗选择。使用考虑该手术相关并发症的标准可以保证对受者进行更好的评估，并让团队为移植后可能出现的不理想结果做好准备。终末期肝病模型（MELD）评分已被扩展用于评估接受包括心脏移植在内的各种手术的肝硬化患者。
分析关于MELD评分及其衍生指标对考虑进行心脏移植的终末期心力衰竭患者预后的了解情况。
对过去十年在PubMed和Lilacs数据库中发表的文献进行综合回顾，使用“心脏移植”“肝病”和“预后”等描述词。从总共找到的111篇文章中，选取了6篇组成样本。
由于排除了国际标准化比值（INR），终末期肝病模型排除国际标准化比值（MELD-XI）评分在研究中得到了最多分析，因为许多心力衰竭患者使用抗凝剂，这可能会改变其数值。MELD及其衍生指标与心脏移植的不理想结果相关。
MELD评分可被视为心脏移植的良好预测指标；然而，进行这种相关性分析的研究仍然很少。
