MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study

Botta, F.; Giannini, E.; Romagnoli, P.; Fasoli, A.; Malfatti, F.; Chiarbonello, B.; Testa, E.; Risso, D.; Colla, G.; Testa, R.
January 2003
Gut;Jan2003, Vol. 52 Issue 1, p134
Academic Journal
Background: Indices for predicting survival are essential for assessing prognosis and assigning priority for liver transplantation in patients with liver cirrhosis. The model for end stage liver disease (MELD) has been proposed as a tool to predict mortality risk in cirrhotic patients. However, this model has not been validated beyond its original setting. Aim: To evaluate the short and medium term survival prognosis of a European series of cirrhotic patients by means of MELD compared with the Child-Pugh score. We also assessed correlations between the MELD scoring system and the degree of impairment of liver function, as evaluated by the monoethylglycinexylidide (MEGX) test. Patients and methods: We retrospectively evaluated survival of a cohort of 129 cirrhotic patients with a follow up period of at least one year. The Child-Pugh score was calculated and the MELD score was computed according to the original formula for each patient. All patients had undergone a MEGX test. Multivariate analysis was performed on all variables to identify the parameters independently associated with one year and six month survival. MELD values were correlated with both Child-Pugh scores and MEGX test results. Results: Thirty one patients died within the first year of follow up. Child-Pugh and MELD scores, and MEGX serum levels were significantly different among patients who survived and those who died. Serum creatinine, international normalised ratio, and MEGX[sub 60] were independently associated with six month mortality while the same variables and the presence of ascites were associated with one year mortality. MELD scores showed significant correlations with both MEGX values and Child-Pugh scores. Conclusions: In a European series of cirrhotic patients the MELD score is an excellent predictor of both short and medium term survival, and performs at least as well as the Child-Pugh score. An increase in MELD score is associated with a decrease in residual liver function.


Related Articles

  • New directions in primary biliary cirrhosis. Bateson, M.C. // BMJ: British Medical Journal (International Edition);12/8/90, Vol. 301 Issue 6764, p1290 

    Focuses on the management of primary biliary cirrhosis. Indication of liver transplantation; Application of chlorambucil; Observation of the ursodeoxycholic acid.

  • Continuing Medical Education Questions: August 2015. Lee, Peter; Esfah, Jamak Modaresi; Tian, Chaorui; Wang, Ming-Hsi; DeVault, Kenneth R // American Journal of Gastroenterology;Aug2015, Vol. 110 Issue 8, p1167 

    A quiz concerning severe alcoholic relapse of patients who undergoes liver transplant for alcoholic liver cirrhosis is presented.

  • Persistence of the intestinal defect in abetalipoproteinaemia after liver transplantation. Braegger, C. P.; Belli, D. C.; Mentha, G.; Steinmann, B. // European Journal of Pediatrics;1998, Vol. 157 Issue 7, p576 

    Abstract A 16-year-old girl is described with abetalipoproteinaemia who underwent liver transplantation for hepatic cirrhosis. After this procedure her serum lipoprotein profile was corrected; however, fat malabsorption and steatorrhea persisted because the primary defect, a mutant microsomal...

  • The Use of Screening and Preventive Therapies for Gastroesophageal Varices in Patients Referred for Evaluation of Orthotopic Liver Transplantation. Arguedas, Miguel R.; McGuire, Brendan M.; Fallon, Michael B.; Abrams, Gary A. // American Journal of Gastroenterology;Mar2001, Vol. 96 Issue 3, p833 

    OBJECTIVE: Screening for varices has been recommended in patients with cirrhosis to prevent variceal hemorrhage (primary prophylaxis). In addition, therapy is recommended after the initial episode of variceal bleeding to prevent recurrence (secondary prophylaxis). However, the degree of...

  • External validation of a prognostic model for predicting survival of cirrhotic patients with refractory ascites. Guardiola, Jordi; Baliellas, Carme; Xiol, Xavier; Fernandez Esparrach, Glòria; Ginès, Pere; Ventura, Pere; Vazquez, Santiago // American Journal of Gastroenterology;Sep2002, Vol. 97 Issue 9, p2374 

    OBJECTIVE:Cirrhotic patients with refractory ascites (RA) have a poor prognosis, although individual survival varies greatly. A model that could predict survival for patients with RA would be helpful in planning treatment. Moreover, in cases of potential liver transplantation, a model of these...

  • Evolution of living donor liver transplantation over 10 years: Experience of a single center. Eguchi, Susumu; Takatsuki, Mitsuhisa; Hidaka, Masaaki; Tajima, Yoshitsugu; Kanematsu, Takashi // Surgery Today;Sep2008, Vol. 38 Issue 9, p795 

    Purpose: To evaluate the changes in living donor liver transplantations (LDLTs) over the last 10 years, we analyzed our experience of performing LDLT in a single center. Methods: We performed 73 LDLTs over the 10 years between 1997 and 2007 in Nagasaki University Hospital, Japan. Results:...

  • Pneumococcal Vaccine Response in Cirrhosis and Liver Transplantation. McCashland, T.M.; Preheim, L.C.; Gentry-Nielsen, M. J. // Journal of Infectious Diseases;2/1/2000, Vol. 181 Issue 2, p757 

    Studies pneumococcal vaccine response in cirrhosis and liver transplantation. Most common cause of bacterial community-acquired pneumonia; Antibody response to pneumococcal vaccination in persons with cirrhosis; Effect of liver transplantation on antibody levels.

  • Hepatology highlights. McLeod, Magnus; Khorasani-Zadeh, Arman; Peltekian, Kevork M. // Annals of Hepatology: Official Journal of the Mexican Associatio;Jan/Feb2015, Vol. 14 Issue 1, p4 

    The article presents abstracts related to hepatology which include the use of boceprevir and telaprevir for chronic genotype 1 hepatitis C virus infection, factors associated in liver transplant patients with hepatocellular carcinoma and mortality in patients with acute decompensation of cirrhosis.

  • Management of complications of cirrhosis in liver transplant candidates. Macedo, Guilherme; Lopes, Susana; Araujo, Fernando; Barroso, Sonia; Maia, Jose Costa; Veloso, Tavarela // American Journal of Gastroenterology;Sep2003 Supplement, Vol. 98, pS90 

    An abstract of the article "Management of Complications of Cirrhosis in Liver Transplant Candidates," by Guilherme Macedo, Susana Lopes, Fernando Araujo, Sonia Barroso, Jose Costa Maia and Tavarela Veloso is presented.

  • Organ tolerance following cadaveric liver transplantation for chronic graft-versus-host disease after allogeneic bone marrow transplantation. Urban, Ch.; Deutschmann, A.; Kerbl, R.; H., Lackner; Schwinger, W.; Konigsrainer, A.; Margreiter, R. // Bone Marrow Transplantation;10/15/2002, Vol. 30 Issue 8, p535 

    Presents a study that examined the effect of orthotopic liver transplantation after the development of cirrhosis of the liver. Details on the dysfunction of the liver; Causes of liver failure; Information on haematolymphopoietic chimerism.


Read the Article


Sign out of this library

Other Topics