ANALYSIS OF THE SURVIVAL OF CIRRHOTIC PATIENTS ENLISTED FOR LIVER TRANSPLANTATION IN THE PRE- AND POST-MELD ERA IN SOUTHERN BRAZIL

Context Transplantation is the only cure for decompensated cirrhosis. Model for End-Stage Liver Disease (MELD) is used in liver allocation. Objectives Comparing survival of enlisted populations in pre- and post-MELD eras and estimating their long-term survival. Methods This is a retrospective study of cirrhotics enlisted for transplantation during pre- and post-MELD eras. Survival curves were generated using Kaplan-Meier’s model. Cox’s model was used to determine risk factors for mortality. Exponential, Weibull’s, normal-log and Gompertz’s models were used to estimate long-term survival. Results The study included 162 patients enlisted in pre-MELD era and 184 in post-MELD period. Kaplan-Meier’s survival curve of patients enlisted in post-MELD era was better than that of pre-MELD period (P = 0.009). This difference remained for long-term estimates, with a survival of 53.54% in 5 years and 44.64% in 10 years for patients enlisted in post-MELD era and of 43.17% and 41.75% for pre-MELD period. Era in which patients had been enlisted (P = 0.010) and MELD score at enlistment (P<0.001) were independently associated to survival with hazard ratios of 0.664 (95% CI-confidence interval = 0.487-0.906) and 1.069 (95% CI = 1.043-1.095). Conclusions MELD-based transplantation policy is superior to chronology-based one, promoting better survival for enlisted patients, even in long-term.

Bibliographic Details

Main Authors:	MATTOS,Ângelo Zambam de, MATTOS,Angelo Alves de, SACCO,Fernanda Karlinski Fernandes, HOPPE,Lísia, OLIVEIRA,Denise Maria Sarti de
Format:	Digital revista
Language:	English
Published:	Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. 2014
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032014000100046
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