Related Experiment Video
Updated: Apr 21, 2026
An Intestine/Liver Microphysiological System for Drug Pharmacokinetic and Toxicological Assessment
Published on: December 3, 2020
D-MELD does not predict post-liver transplantation survival: a single-center experience from Brazil
Ane M Costabeber1, Lívia C Lionço1, Cláudio Marroni2
1Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
Background:
The D-MELD score was designed to prevent donor-recipient matches with a high risk of unfavorable outcome. The main objective of the present study was to assess the predictive value of the DMELD score for 1-month and 3-month post-transplant mortality in a cohort of patients who underwent deceased-donor liver transplantation in Southern Brazil.
Material And Methods:
A cohort study was conducted. Receiver operating characteristic c-statistics were used to determine the ability of the D-MELD score to predict mortality. The Kaplan-Meier method was used to analyze survival as a function of time regarding D-MELD scores, and the Cox model was employed to assess the association between D-MELD and mortality.
Results:
Most recipients were male, with a mean age of 54.3 ± 9.6 years (n = 233 transplants). Mean donor age was 44.9 ± 16.8 years (19.3% of donors were aged ≥ 60 years). Mean MELD and D-MELD scores were 16.3 ± 7.1 and 733.1 ± 437.8 respectively. Overall survival at 1 and 3 months was 83.6%. The c-statistic value for 1- and 3-month mortality was < 0.5 for the D-MELD. Analysis of Kaplan-Meier curves for groups with D-MELD scores < 1,600 and ≥ 1,600 did not show statistically significant differences in survival (p = 0.722).
Conclusion:
D-MELD scores were unable to predict survival in this cohort of Brazilian liver transplant recipients.
Insights
The D-MELD score did not effectively predict 1-month or 3-month mortality in deceased-donor liver transplant recipients in Southern Brazil. This study found the D-MELD score to be unreliable for assessing post-transplant survival outcomes.
Area of Science:
- Transplantation Medicine
- Hepatology
- Biostatistics
Background:
- The Donor-Risk-MELD (D-MELD) score was developed to identify high-risk donor-recipient liver transplant matches.
- Assessing the predictive accuracy of the D-MELD score for early post-transplant mortality is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the predictive performance of the D-MELD score for 1-month and 3-month mortality after deceased-donor liver transplantation.
- To determine the reliability of the D-MELD score in a Brazilian cohort.
Main Methods:
- A cohort study analyzed data from deceased-donor liver transplant recipients in Southern Brazil.
- Receiver operating characteristic (c-statistic) analysis assessed the D-MELD score's predictive ability for mortality.
- Kaplan-Meier and Cox regression models were used to analyze survival and the association between D-MELD scores and mortality.
Main Results:
- The study included 233 liver transplant recipients with a mean age of 54.3 years; mean donor age was 44.9 years.
- The D-MELD score demonstrated a c-statistic value below 0.5 for predicting 1- and 3-month mortality.
- No statistically significant difference in survival was observed between D-MELD score groups (<1,600 vs. ≥1,600).
Conclusions:
- The D-MELD score was found to be ineffective in predicting 1-month and 3-month survival in this cohort.
- The findings suggest limitations in the D-MELD score's applicability for risk stratification in Brazilian liver transplant recipients.
