Iwamura Sena, Kaido Toshimi, Morita Satoshi, Miyachi Yosuke, Yao Siyuan, Shirai Hisaya, Kobayashi Atsushi, Hamaguchi Yuhei, Kamo Naoko, Yagi Shintaro, Uemoto Shinji
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Surgery, Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hepatol Res. 2019 Jun;49(6):687-694. doi: 10.1111/hepr.13320. Epub 2019 Mar 1.
To clarify the risk-benefit point of the Model for End-stage Liver Disease (MELD) score in patients waiting for deceased-donor liver transplantation (DDLT).
The present study retrospectively investigated 213 patients registered on the waiting list at Kyoto University (Kyoto, Japan) between 2005 and 2016. Patients were stratified by MELD score (6-9/10-14/15-20/21-30/31-40) and classified into two groups: the DDLT group (30 patients) and the waiting group (183 patients). Their post-registration mortality risk and long-term survival were compared.
For all MELD categories, the mortality risk was lower in the DDLT group than in the waiting group. The hazard ratio of post-registration mortality decreased in the DDLT group compared to the waiting group as the MELD score increased (0.36/0.12/0.06/0.042/0.004). Survival was significantly better among patients in the DDLT group with a MELD score of 15 or more than among patients in the waiting group.
For all MELD categories, DDLT reduced the mortality risk of patients on the waiting list.
明确终末期肝病模型（MELD）评分在等待尸体供肝肝移植（DDLT）患者中的风险效益点。
本研究回顾性调查了2005年至2016年间在日本京都大学等待名单上登记的213例患者。患者按MELD评分分层（6 - 9/10 - 14/15 - 20/21 - 30/31 - 40），并分为两组：DDLT组（30例患者）和等待组（183例患者）。比较他们登记后的死亡风险和长期生存率。
对于所有MELD类别，DDLT组的死亡风险低于等待组。随着MELD评分增加，DDLT组登记后死亡的风险比相对于等待组降低（0.36/0.12/0.06/0.042/0.004）。MELD评分为15或更高的DDLT组患者的生存率显著高于等待组患者。
对于所有MELD类别，DDLT降低了等待名单上患者的死亡风险。
