The Impact of OPTN MELD Score on Post-Liver Transplant Mortality

Acute-on-chronic liver failure (ACLF) is a life-threatening condition that often affects patients with cirrhosis, characterized by sudden onset and rapid progression of underlying hepatic dysfunction. The severity of clinical decompensation in these patients can have a significant impact on post-liver transplant (LT) outcomes.

Using the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) registry, researchers analyzed post-LT mortality among adult LT recipients based on the degree of fluctuation in MELD score during the 30-day period prior to LT surgery. The study found that a ≥5 points rise in MELD score over 30 days in the setting of ACLF has been shown to predict pre-LT waitlist mortality, but the data are conflicting in terms of post-LT survival.

The study also looked at the impact of D-MELD as a continuous and categorical variable on early, 30-day post-LT mortality. The results showed that one-point incremental increase in pre-operative D-MELD was associated with higher 30-day post-LT mortality. Moreover, pre-operative D-MELD >10 was associated with nearly a two-fold increased risk for 30-day post-LT mortality compared to D-MELD 0-4.

The study highlights the importance of considering the OPTN MELD score in predicting post-LT outcomes and identifying patients who may be at higher risk of mortality. The findings suggest that clinicians should consider the degree of fluctuation in MELD score during the pre-transplant period when evaluating patients for LT surgery, as this may help inform treatment decisions and improve patient outcomes.

Overall, this study demonstrates the significance of OPTN MELD score in predicting post-LT mortality in patients with ACLF. Further research is needed to fully understand the relationship between MELD score and post-LT outcomes, but these findings provide valuable insights for clinicians and researchers alike.

Optn meld score