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Model for end-stage liver disease score predicts complications after liver transplantation

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Abstract

Purpose

Increased model for end-stage liver disease (MELD) score measured in the early postoperative course is associated with one-year mortality and graft loss. However, the correlation with postoperative complications has not been investigated. The aim of this study was to investigate the association between postoperative MELD score and subsequent complications.

Methods

Adult liver transplant recipients transplanted from January 2011 until December 2016 were included. MELD score days 1–5 were correlated with complications day 6–30, subdivided into type and severity according to Clavien-Dindo classification.

Results

We included 246 adult liver transplant recipients. Between days 6 and 30, 671 complications occurred in 201 of the patients (82%) corresponding to 64% of all postoperative complications in the whole postoperative period (days 0–30). In multivariate analyses adjusted for recipient gender and age, preoperative MELD score, and Eurotransplant Donor Risk Index, postoperative MELD score was significantly associated with having one or more complications, any type of complication except cardiovascular and renal complications, and complication severity.

Conclusions

Postoperative MELD score days 1–5 were associated with complications arising in the subsequent period 6–30 days after transplantation. An increased MELD score should heighten the clinician’s awareness of a possible complication.

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Data Availability

Data available upon request.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Hans-Christian Pommergaard, Thomas Røjkjær Daugaard, Andreas Arendtsen Rostved, Nicolai Aagaard Schultz, Jens Hillingsø, Paul Suno Krohn & Allan Rasmussen

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  1. Hans-Christian Pommergaard
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  2. Thomas Røjkjær Daugaard
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  3. Andreas Arendtsen Rostved
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  4. Nicolai Aagaard Schultz
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  5. Jens Hillingsø
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  6. Paul Suno Krohn
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  7. Allan Rasmussen
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Contributions

Hans-Christian Pommergaard contributed in the conception and design, data analysis and interpretation of results, writing the first draft, critical revision, and final approval. Thomas Røjkjær Daugaard contributed in the conception and design, interpretation of results, critical revision, and final approval. Andreas Arendtsen Rostved contributed in the conception and design, interpretation of results, critical revision, and final approval. Nicolai Aagaard Schultz contributed in the interpretation of results, critical revision, and final approval. Jens Hillingsø contributed in the interpretation of results, critical revision, and final approval. Paul Suno Krohn contributed in the interpretation of results, critical revision, and final approval. Allan Rasmussen contributed in the conception and design, interpretation of results, acquisition of data, critical revision, and final approval.

Corresponding author

Correspondence to Hans-Christian Pommergaard.

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Conflicts of interest

There were no conflicts of interest for any of the authors.

Ethical approval

The study was approved by the Danish Data Protection Agency (2012-58-0004) and the Danish Patient Safety Authority (3-3013-1948-1).

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All authors fulfill the four criteria for authorship of the ICMJE.

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Pommergaard, HC., Daugaard, T.R., Rostved, A.A. et al. Model for end-stage liver disease score predicts complications after liver transplantation. Langenbecks Arch Surg 406, 55–65 (2021). https://doi.org/10.1007/s00423-020-02018-3

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  • DOI: https://doi.org/10.1007/s00423-020-02018-3

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