| BackgroundLiver transplantation has been the best treatment modality for patients with end-stage liver diseases. Recently, to overcome the critical shortage of deceased organ donation, living donor liver transplantation (LDLT) is driven to develop rapidly. However, it is still controversial whether LDLT suitable for benign high MELD score recipients.Patients and MethodsBetween October 2006 and December 2009,71 benign end-stage liver disease patients following LDLT in the first affiliated hospital, school of medicine. Zhejiang University were retrospective analyzed. According to the MELD score before transplantation, all the patients were divided into two groups:MELD≥>30 (Hi-MELD group. n=28). MELD<30 (Low-MELD group, n=43). Clinical variables were collected and analyzed by the software of SPSS 16.0. Continuous variables were expressed as Mean=SD and comparisons between groups were done by the t test. Categorical variables were compared using (?)test. The cumulative survival was estimated by the Kaplan-Meier method and compared using the log rank test. ResultsPre-transplant MELD scores were 34.86±3.58 and 19.91±5.89, respectively. For pre-transplant variations, hepatic encephalopathy, hepatorenal syndrome, intubation rates, artificial liver support system rates were significantly greater in the high versus low MELD score group (p<0.05). Intro-operative characteristics were similar between groups. High MELD score recipients had more frequent postoperative infection, pneumonia, acute rejection, renal failure, wound healing, re-exploration rates; While no differences were observed in rates of biliary complications, hepatic artery thrombosis. Recipients with MELD≥30 versus<30 had a similar 1-year (Low:95.3% vs. Hi:78.6%), 2-year (Low:90.7% vs. Hi:78.6%), and 3-year (Low:90.7% vs. Hi:78.6%) patient survival after LDLT (P=0.126). The value of ALT, AST, TB, INR et al was gradually decreasing. LDLT provide excellent graft function.ConclusionLDLT is an effective and life-saving modality for high MELD score recipients. A high MELD score alone should not be an absolute contraindication to living liver donation, especially when deceased donor organs are scare. |
