Does the Model for End-Stage Liver Disease Predict Primary Graft Dysfunction?

Purpose The Model for End-Stage Liver Disease (MELD) has been used to assess risk in patients awaiting liver transplant. More recently, MELD has been applied to patients with end-stage heart disease and has been demonstrated to reveal patients at high risk for mortality after heart transplantation (HTx). It is not known whether MELD score can predict severe PGD as per the new ISHLT scale. Methods Between 2010 and 2017, we identified 25 heart transplant patients who developed severe PGD supported by ECMO. This group was compared to 670 patients who did not have PGD. The pre-transplant MELD score was calculated for each group to see if there was a correlation to PGD. Results The MELD score was similar between patients that developed PGD and those that did not develop PGD (see table). Characteristics of the two groups demonstrated that the MELD individual criteria revealed that pre-transplant creatinine and total bilirubin were higher in the No PGD group but did not result in a difference between group MELD scores. Conclusion The MELD score may predict poor outcome after HTx; however, it does not appear to be a predictor for PGD.