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The model for end-stage liver disease score is useful for predicting economic outcomes in adult cases of living donor liver transplantation

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Abstract

Background

The model for end-stage liver disease (MELD) is useful for assessing the recipients of liver transplants, namely, deceased-donor transplantation. The application of MELD for living donor liver transplantation (LDLT) is under investigation. Thus, the aim of this study was to analyze the impact of the MELD score in LDLT in Japan.

Methods

Seventeen adult cases of LDLT during 2001 to 2005 were enrolled. Indications for LDLT were primary biliary cirrhosis, seven; liver cirrhosis, two; hepatocellular carcinoma (HCC), three; metabolic liver disease, one; primary sclerosing cholangitis, two; Caroli's disease, one; and biliary atresia, one. Total medical charges during the operative periods were retrospectively evaluated. The united network of organ sharing (UNOS) modified was obtained using preoperative clinical data.

Results

The average medical expense of the 17 cases was approximately $97 901. The UNOS-modified MELD score was 22.1. A statistically significant positive correlation was found between the MELD score and medical expense (P = 0.0086, ρ = 0.657), and between the MELD score and the length of stay in the intensive care unit (ICU) (P = 0.0396, ρ = 0.515). The cause of the liver disease leading to transplantation was not related to MELD score, medical expense, or length of ICU stay.

Conclusions

Although not originally designed for the application to LDLT, the MELD score is useful for predicting medical expenses in LDLT. Similar to those of deceased-donor liver transplantation, the disadvantage of high medical expenses associated with a high MELD score allow consideration of an earlier elective operation in suitable cases.

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Authors and Affiliations

  1. Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, 980-8574, Japan

    Takayuki Kogure, Yoshiyuki Ueno, Noriatsu Kanno, Yoko Yamagiwa, Koji Fukushima & Tooru Shimosegawa

  2. Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Japan

    Naoki Kawagishi & Susumu Satomi

Authors
  1. Takayuki Kogure
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  2. Yoshiyuki Ueno
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  3. Naoki Kawagishi
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  4. Noriatsu Kanno
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  5. Yoko Yamagiwa
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  6. Koji Fukushima
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  7. Susumu Satomi
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  8. Tooru Shimosegawa
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Kogure, T., Ueno, Y., Kawagishi, N. et al. The model for end-stage liver disease score is useful for predicting economic outcomes in adult cases of living donor liver transplantation. J Gastroenterol 41, 1005–1010 (2006). https://doi.org/10.1007/s00535-006-1887-x

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  • DOI: https://doi.org/10.1007/s00535-006-1887-x

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