The data from the remaining 6,014 patients were enrolled and used for analysis. Another 762 patients were not accounted because of incomplete laboratory and clinical data. We excluded those who underwent re-transplantation (n = 449) or combined liver-kidney transplantation (n = 185), or had hepatocellular carcinoma (n = 7,146). The study population included adult cirrhotic patients (>18 years) who underwent liver transplantation between January 2003 and December 2010 (n = 14,220). The data used in this study was extracted from CLTR database. With the most accurate prognostic prediction model recognized, the secondary objective is to identify patients who should be excluded from waiting list to prevent wasteful transplantation. In the present study, we aim to evaluate the efficacy of pre-transplant MELD and other scoring systems in the prediction of post-transplant survival using a large cohort of patients from the China Liver Transplant Registry (CLTR) database. Although the predictive value of MELD and its modified formulas in liver transplant candidates has been well established, there are limited data focusing on the post-transplant survival. A study evaluated the prognostic ability of six prognostic formulas in 487 candidates with cirrhosis and found MELD-sodium (MELD-Na) and integrated MELD (iMELD) were better prognostic models than MELD to predict the drop-out rate among patients awaiting transplantation 9.
#Meld score prognosis series
Therefore, a series of modified MELD formulas have been developed to better predict the patient survival on the waiting list 3, 4, 5, 6, 7, 8. Above all, cirrhotic complications such as persistent ascites and hyponatremia, which could contribute to poor prognosis, are not included in the MELD formula. It achieved great improvement in donor liver allocation compared with Child-Turcotte-Pugh (CTP) 2 and is widely used for organ allocation nowadays. Since 2002, MELD has been implemented as a liver allocation tool in the USA. It has been validated as a good predictor of mortality for a broader range of patients with end-stage liver disease, including candidates on the waiting list for liver transplantation 1. The Model for End-stage Liver Disease (MELD) scoring system was developed to estimate the survival of patients undergoing transjugular intrahepatic portosystemic shunts 1. Among patients with MELD score >35, a new prognostic model can identify the sickest patients who should be excluded from waiting list to prevent wasteful transplantation. In conclusion, MELD is superior to other score systems in predicting short-term post-transplant survival in patients with HBV-related liver disease. Among patients with MELD score >35, a new prognostic model based on serum creatinine, need for hemodialysis and moderate ascites could identify the sickest one. Patient survivals in different MELD categories were of statistically significant difference. In hepatitis C virus and Alcohol groups, the predictive ability did not differ significantly between MELD and other models. In hepatitis B virus (HBV) group, MELD, uMELD and MELD-AS showed good predictive accuracies at 3-month mortality after liver transplantation by comparison with other five models, MELD presented the best ability in predicting 3-month, 6-month and 1-year mortality, showing a significantly better predictive ability than UKELD and iMELD. iMELD, UKELD, MELD-AS, CTP, and mCTP) in predicting the post-transplant mortality, we analyzed the data of 6,014 adult cirrhotic patients who underwent liver transplantation between January 2003 and December 2010 from the China Liver Transplant Registry database. To compare the performance of eight score systems (MELD, uMELD, MELD-Na.
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