Stratifying Mortality in a Model for End-Stage Liver Disease Waiting List: A Brazilian Single-Center Study

Area of Science:

• Hepatology
• Transplantation Medicine
• Gastroenterology

Background:

• The Model for End-Stage Liver Disease (MELD) score is a key predictor of mortality in cirrhosis.
• However, MELD does not account for liver disease etiology or portal vein thrombosis (PVT).
• The impact of these factors on liver transplant waiting list outcomes remains unclear.

Purpose of the Study:

• To investigate the influence of liver disease etiology on mortality and transplantation rates.
• To assess the impact of portal vein thrombosis (PVT) on patient outcomes while on the liver waiting list.

Main Methods:

• A cohort of 465 adult patients on the liver waiting list was followed for one year.
• Patients were grouped by liver disease etiology and presence of PVT.
• Mortality and transplantation rates were analyzed.

Main Results:

• Hepatitis C, alcoholic cirrhosis, and cryptogenic cirrhosis were the most common etiologies.
• Higher mortality was observed in nonalcoholic steatohepatitis (NASH) and alcoholic cirrhosis patients.
• Viral, autoimmune, and biliary diseases had higher transplantation rates.
• PVT was present in 16.7% of patients, with no significant impact on outcomes.

Conclusions:

• NASH and alcoholic liver disease are associated with increased waiting list mortality.
• Viral and autoimmune hepatitis correlate with higher transplantation rates.
• Portal vein thrombosis does not significantly influence outcomes for liver transplant candidates.