Evaluation of MELD and CTP scoring system in patients selected for liver transplantation
Background Indices for predicting of survival are essential tools for assessing prognosis and establishing priority for liver transplantation. Objectives To investigate the prognostic criteria of CTP and MELD scales for short and long-term survival prognosis in a waitlist of patients selected for liver transplantation. Methods The group of 236 patients with diagnosis of different chronic liver disease was investigated in period of 4.5 years. Persons with CTP scoring 310 were included into the waitlist for liver transplantation. Other inclusion criteria were based on CTP 37 plus one or more liver cirrhosis complications. The cumulative and mean survivals were evaluated according to the Kaplan-Meier statistical analysis. The clinical status of waitlist patients was evaluated by applying the CTP and MELD. The short and long-term survival prognosis was assessed. The odds ratios with 95% CI in univariate analysis were evaluated. Results During the period of 4.5 years 45 persons were selected for waitlist group. Mortality rate was 51.1%, average survival – 17.9 months. The CTP scores were as follows: 15.6% of patients had <9 scores, 71.1% – 10–11 and 13.3% – 312. The highest mortality rate was in the group with CTP scores 312. MELD scoring resulted in following distribution of patients: 4.4% – <10, 26.6% – 11–12, 46.6% – 18–24 and 22.2% – 25–40 scores. The shortest survival was in the group with the highest scores. It was established the significant difference for short-term survival (less than 3 months) prognosis in MELD scale. CTP scores had no predictive influence for survival during 3 months. Also both the CTP and MELD scoring had high prognostic value for prediction of the long-term survival (more than 3 months). [...].