Impact of the Model for End-stage Liver Disease (MELD) score on liver transplantation in Greece.

Abstract Introduction The impact of preoperative Model for End-stage Liver Disease (MELD) score in postoperative mortality remains unclear. The assumption that patients with a higher MELD score will have a higher mortality rate is not confirmed and studies are contradictory. Aim The study of the clinical course of patients with a higher MELD score and its impact in immediate and later mortality in comparison with patients with a lower MELD score in the only liver transplantation center in Greece. Method We retrospectively studied 71 patients who underwent orthotopic liver transplantation (OLT) in the time period between 1-1-2011 and 31-12-2013. The patients were divided into 2 groups: Group A with a MELD score ≥23 and Group B with a MELD score  Results In the patients with a MELD score ≥23 the duration of mechanical ventilation and length of stay in the ICU were prolonged ( P  = .013 and .009, respectively), the transfusions were more ( P  = .005), and the rates of ICU readmissions (22.5% vs 7.31%, P  = .001) and infections (42.5% vs 17.5%, P  = .011) were higher. Thirty-day mortality did not differ between the 2 groups ( P  = .420), but there was a statistically significant difference in morbidity and in 180-day mortality. Conclusion The patients with a higher MELD score have more complex pathophysiology. This score seems to affect morbidity and late, but not early, mortality.