What question did this study set out to answer?

To assess trends and graft survival outcomes associated with high Model for End-Stage Liver Disease (MELD) scores among recipients of living donor liver transplantation.

July 25, 2023Liver Transplantation

Increasing practice and acceptable outcomes of high-MELD living donor liver transplantation in the USA

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Authors

AAAhmad AnoutiThe University of Texas Southwestern Medical Center MPMadhukar S. PatelCedars-Sinai Medical Center LVLisa B. VanWagnerGeneral / Preventive / Lipids

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Implication

Cohort study reveals acceptable graft survival for high-MELD living donor liver transplant recipients, suggesting expanding living donation could safely alleviate organ shortages.

Key Points

To assess trends and graft survival outcomes associated with high Model for End-Stage Liver Disease (MELD) scores among recipients of living donor liver transplantation.
Analyzed UNOS registry data (2010–2021) for 3,558 living donor liver transplant (LDLT) recipients stratified by MELD score: low (<15; n=1,605), intermediate (15–24; n=1,616), and high (≥25; n=337).
Assessed graft survival using Kaplan-Meier analyses and multivariable Cox proportional hazards modeling, comparing outcomes across LDLT MELD tiers and against recipients of donation after brain death (DBDT) liver transplants.
The total annual volume of LDLTs increased from 282 to 569 over the study period, while the proportion of high-MELD LDLTs rose from 3.9% to 7.7%.
Graft survival was significantly lower in high-MELD versus low-MELD LDLT recipients (adjusted HR = 1.36, 95% CI: 1.03–1.79), though 5-year graft survival remained above 70.0% in both cohorts.
High-MELD LDLT yielded 5-year graft survival comparable to high-MELD DBDT transplants (71.5% vs. 77.3%; adjusted HR = 1.25, 95% CI: 0.99–1.58), with low center volume (<3 cases/year) and life support dependency predicting graft failure.

Cite This Study

Anouti et al. (2023) studied this question.

synapsesocial.com/papers/6a198b08bdd35483aadeb9cc https://doi.org/10.1097/lvt.0000000000000228

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Implication

Cohort study reveals acceptable graft survival for high-MELD living donor liver transplant recipients, suggesting expanding living donation could safely alleviate organ shortages.

Increasing practice and acceptable outcomes of high-MELD living donor liver transplantation in the USA

Discussion

Member takes

Implication

Key Points

Cite This Study

Increasing practice and acceptable outcomes of high-MELD living donor liver transplantation in the USA

Discussion

Member takes

Implication

Key Points

Cite This Study

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