Related Experiment Video
Updated: Jun 28, 2026
Extended 78% Hepatectomy in a Mouse Surgical Model
Published on: May 24, 2024
Model for end-stage liver disease can predict very early outcome after liver transplantation
J Briceño1, J M Sánchez-Hidalgo, A Naranjo
1Liver Transplantation Unit, Hospital Reina Sofía, Cordoba, Spain. javibriceno@hotmail.com
Abstract:
Postoperative Model for End-stage Liver Disease (MELD) values have never been assessed to predict very early (<1 week) death after liver transplantation (OLT). We retrospectively reviewed 275 consecutive OLTs performed in 252 recipients reported in a prospective database. We calculated the MELD score (pre-MELD) and consecutive postoperative MELD (post-MELD) scores computed daily during the first postoperative week and on days 15 and 30 after OLT. Post-MELD scores from nonsurviving recipients displayed on a scatterplot of immediate probability of death were adjusted to the best goodness-of-fit curve, and, finally, depicted graphically as a receiver operating characteristic (ROC) curve. Nonsurviving recipients showed higher post-MELD scores: day 1: 23.5 versus 16.6 (P = .05); day 3: 25.1 versus 12.5 (P = .000); day 5: 25.7 versus 11.8 (P = .000); and day 7: 22.1 versus 10.2 (P = .000). Overall comparisons were performed using a time-dependent general linear regression model, revealing higher post-MELD scores for nonsurviving recipients, irrespective of postoperative time (P = .002). The best goodness-of-fit curve was displayed when adjusting to a theoretical exponential regression curve calculated as follows: Probability of dying within the first week (%) = 3.36 x e(0.079 x (post-MELD)) (r = .89; P = .000). The area under the ROC curve was 0.783 (95% confidence interval, 0.630-0.935; P = .001). The model had a positive predictive value of 82.3%, a negative predictive value of 33.1%, and an accuracy of 79.2%. In conclusion, this study corroborated the suggestion that the MELD score may serve as a reliable tool to assess very early death after OLT.
Insights
Postoperative Model for End-stage Liver Disease (MELD) scores can predict very early death after liver transplantation (OLT). Higher postoperative MELD scores in the first week accurately identify patients at high risk for mortality post-OLT.
Area of Science:
- Hepatology
- Transplantation Surgery
- Medical Statistics
Background:
- Assessing early mortality risk after liver transplantation (OLT) is crucial for patient management.
- The Model for End-stage Liver Disease (MELD) score is established for liver disease severity but its early postoperative predictive value is unexamined.
Purpose of the Study:
- To evaluate the utility of postoperative MELD (post-MELD) scores in predicting very early (<1 week) mortality following OLT.
Main Methods:
- Retrospective analysis of 275 OLTs from a prospective database.
- Daily calculation of post-MELD scores during the first postoperative week, plus days 15 and 30.
- Development of a predictive model using regression analysis and receiver operating characteristic (ROC) curves.
Main Results:
- Nonsurviving recipients consistently exhibited significantly higher post-MELD scores from day 1 through day 7 (P < .05).
- A derived exponential regression model (Probability of dying within the first week (%) = 3.36 x e(0.079 x (post-MELD))) showed strong correlation (r = .89; P = .000).
- The ROC curve analysis yielded an area under the curve of 0.783 (P = .001), with 82.3% positive predictive value and 79.2% accuracy.
Conclusions:
- Postoperative MELD scores are a reliable tool for predicting very early mortality risk after liver transplantation.
- The developed predictive model demonstrates significant accuracy in identifying high-risk patients within the first week post-OLT.
