Comparative analysis between MELD score vs. UNOS Status for predicting post-transplant mortality in liver recipients.

Introduction - The Model for End-Stage Liver Disease (MELD) score has replaced the conventional UNOS statuses 3/2B/2A to assess risk for mortality in patients awaiting liver transplantation (LT). However, further studies should be performed to evaluate the predictive value of the MELD score for posttransplant mortality. Patients and Methods - A group of adult patients that underwent a LT procedure in our Department during 01/01/2000-30/06/2004 period (n=140, M 100/F 40; age: 52.79\ub18.93) was enrolled as follows: i) classification in UNOS status 2A (n=13; 9.28%), 2B (n=123; 87.85%), or 3 (n=4; 2.85%); ii) no retransplantation; 3) full dataset about cadaveric donors (M 92/F 48; age: 49.17\ub119.25). For each patient was collected the last MELD calculated before LT. The patients were stratified for MELD score as follows: MELD 0-10, n=12; 11-18, n=61; 19-24, n=33; >25, n=34. Statistical analysis was performed by using Cohen\u2019s k for inter-rate agreement and c-statistic for Receiver Operating Characteristic (ROC) curves. Results - A poor inter-rate agreement was found by Cohen\u2019s k (k=0.048) in UNOS 2B patients for MELD score (MELD 0-10, n=10; 11-18, n=55; 19-24, n=30; >25, n=28). No significance occurred between MELD and UNOS ROC curves for patients mortality at 1 month (P=0.996), 3 months (P=0.714), 6 months (P=0.986), and 1 year (P=0.967). Conclusions - In this study, no statistical differences was found between MELD score and conventional UNOS statuses in order to sensibility for posttransplant mortality in liver recipients