MELD score predicts 1‐year patient survival post‐orthotopic liver transplantation
MELD score predicts 1‐year patient survival post‐orthotopic liver transplantation
复制标题
DOI：
10.1053/jlts.2003.50090
复制
发表时间：
2003-05
影响因子：
4.6
通讯作者：
S. Saab;Victor S. Wang;Ayman B. Ibrahim;F. Durazo;Steven‐Huy B. Han;D. Farmer;H. Yersiz;M. Morrisey;L. Goldstein;R. Ghobrial;R. Busuttil
中科院分区：
文献类型：
--
作者：
S. Saab;Victor S. Wang;Ayman B. Ibrahim;F. Durazo;Steven‐Huy B. Han;D. Farmer;H. Yersiz;M. Morrisey;L. Goldstein;R. Ghobrial;R. Busuttil
终末期肝病模型(MELD)是等待原位肝移植(OLT)患者的重要预测指标。然而，该模型与移植后患者存活率的关系尚不清楚。我们研究了在加州大学洛杉矶分校接受原位肝移植的404名成年患者的1年存活率。根据MELD分层和器官共享联合网络(UNOS)状态，采用比例危险Cox回归分析评估患者生存的风险率。用COX模型比较MELD层和UNOS状态患者的生存率差异。使用不同MELD层的患者1年生存率有显著差异(P=.0006)，而根据UNOS状态有趋势(P=.051)。具有较高的MELD评分(>；36，风险比3.9；95%可信区间1.55，10.27)和更紧急的UNOS状态(2A；风险比，1.99；95%可信区间1.07，3.7)的原位肝移植受者的死亡率较高。与UNOS状态相比，在肝移植受者中，MELD层与患者1年存活率的相关性更好。MELD评分越高，患者存活率越差。
The Model for End‐Stage Liver Disease (MELD) is an important predictor in patients awaiting orthotopic liver transplantation (OLT). However, the model's association with posttransplant patient survival is unclear. We studied 1‐year patient survival in 404 adult patients who underwent OLT at the University of California Los Angeles. The hazard rates of patient survival according to the MELD strata and United Network for Organ Sharing (UNOS) statuses were assessed by Proportional Hazard Cox regression analysis. The difference in survival for MELD strata and UNOS status were compared using the Cox model. There was a significant difference in 1‐year patient (P = .0006) survival using different MELD strata, whereas there was a trend according to UNOS status (P = .051). Increased rate of death was observed in recipients of OLT with higher MELD scores (> 36, hazard ratio 3.9; 95% CI 1.55, 10.27) and more urgent UNOS status (2A; hazard ratio, 1.99; 95% CI 1.07, 3.7). The MELD stratum is better associated with 1‐year patient survival in liver transplant recipients than UNOS statuses. Patient survival was worse with higher MELD scores.