eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
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2/2022
vol. 8
 
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abstract:
Original paper

The predictive value of MELDNa (model for end-stage liver disease-sodium) and mean platelet volume/platelet count for patients’ 30-day mortality after liver transplantation

Vecihe Bayrak
1
,
Mehmet Çağatay Gürkök
2
,
Ferhan Demirer Aydemir
1
,
Bişar Ergün
1
,
Tufan Egeli
3
,
Nurcan Şentürk Durukan
4
,
Tarkan Ünek
3
,
Necati Gökmen
5

  1. Department of Internal Medicine, Adult Intensive Care Unit, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
  2. Department of General and Digestive Surgery, Adult Intensive Care Unit, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
  3. Department of General Surgery, Hepatopancreaticobiliary Surgery and Liver Transplantation Unit, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
  4. Department of Public Health, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
  5. Department of Anesthesia and Reanimation, Adult Intensive Care Unit,Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
Clin Exp HEPATOL 2022; 8, 2: 111-117
DOI: https://doi.org/10.5114/ceh.2022.114907
Online publish date: 2022/03/31
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Aim of the study
To investigate the disease-specific score and improve the existing scores to better determine the prognosis of patients after liver transplantation (LT). For this purpose, we evaluated the relationship of prognostic scores with 30-day mortality after LT. In addition, we planned to investigate whether the mean platelet volume/platelet count (MPR) would contribute to score improvement.

Material and methods
A total of 178 adult patients admitted to the intensive care unit after LT in our hospital between 2011 and 2019 were retrospectively analyzed. Model for end-stage liver disease-sodium (MELDNa), Child-Turcotte-Pugh (CTP) score, and MPR values were compared in patients with and without 30-day mortality who underwent LT. Logistic regression analysis was performed to determine the predictive factors for mortality. A model was created with multivariate analysis.

Results
Our study included 135 (75.8%) male and 43 (24.2%) female patients. There was a significant difference in the postLT-MELDNa score in the evaluation between those with and without mortality (p < 0.001). Age, postLT-MELDNa and CTP score were found to be significant in terms of the prediction of 30-day mortality in the univariate analysis (p < 0.05). mean platelet volume (MPV) and MPR were not significant in univariate analysis. Multivariate analysis revealed a model in which age and postLT-MELDNa were significant.

Conclusions
In our study, postLT-MELDNa predicted 30-day mortality and was much more effective in predicting mortality when evaluated with age. The MELDNa score, which is currently used in the prognosis of candidates awaiting LT, may be useful for the prognosis of patients after LT in intensive care units.

keywords:

ICU mortality, ICU scores, MPV/PLT, liver transplant patient, Child-Turcotte-Pugh score
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