Nous avons mené un examen rétrospectif des dossiers de patients ayant subi une greffe de foie dans le même établissement canadien entre 2012 et 2017. Les objectifs secondaires consistaient à possiblement déterminer des prédicteurs indépendants de défaillance du greffon et de mortalité du patient. Cette étude visait principalement à mesurer le taux de survie des receveurs ayant un score MELD élevé (> 35) et faible (≤ 35) ainsi que le taux de survie du greffon pour chaque catégorie. Les greffes de foie chez les patients ayant un score MELD (Model for End-Stage Liver Disease) élevé sont de plus en plus fréquentes, mais le corpus de publications canadiennes concernant les résultats de ces greffes est limité. D-MELD may potentially be used as an adjunct in determining risk of graft failure in recipients with high MELD scores. Graft survival was significantly lower in recipients with MELD scores above 35. No difference in patient mortality was found between MELD groups. When MELD was replaced with D-MELD (donor age × recipient MELD), it predicted graft failure but not patient survival. Prior liver transplant was an independent predictor of patient mortality, and no independent predictors of graft failure were identified.

One- and 3-year graft survival in recipients with MELD scores of 35 or lower was 91.7% and 90.9% versus 77.2% and 72.8% in recipients with MELD scores above 35 ( p < 0.001). One- and 3-year patient survival in recipients with MELD scores of 35 or lower was 93.1% and 84.9% versus 85.0% and 80.0% in recipients with MELD scores above 35 ( p = 0.37). Patients with high MELD scores had higher rates of pretransplant acute kidney injury and dialysis ( p < 0.001), admission to the intensive care unit (ICU) or intubation ( p < 0.001), intraoperative blood product transfusions ( p < 0.001) and post-transplantation acute kidney injury and dialysis ( p < 0.001), as well as longer ICU ( p < 0.001) and hospital stays ( p = 0.002). We conducted a retrospective chart review of patients undergoing liver transplantation at a single Canadian centre from 2012 to 2017.Ī total of 332 patients were included in the study: 280 patients had a MELD score of 35 or lower, and 52 had a MELD score above 35. Secondary objectives were to potentially identify independent predictors of graft failure and patient mortality. The primary objective of this study was to assess patient and graft survival among recipients with high (> 35) and low (≤ 35) MELD scores. Canadian literature regarding the outcomes of liver transplantation in recipients with high MELD scores is limited. The frequency with which patients with high Model for End-Stage Liver Disease (MELD) scores undergo liver transplantation has been increasing.

High meld score liver transplant