Modified Model for End-Stage Liver Disease eXcluding INR (MELD-XI) Score Predicts Early Death After Pediatric Heart Transplantation

The Annals of Thoracic Surgery
Joshua C GrimmLuca A Vricella

Abstract

We sought to determine the ability of the Model for End-Stage Liver Disease eXcluding INR (MELD-XI) to predict short-term and long-term outcomes in pediatric patients undergoing orthotopic heart transplant. The United Network for Organ Sharing Database was queried for all pediatric patients (aged 1 to 18 years) undergoing orthotopic heart transplant from 2000 to 2012. The logarithmic relationship between the serum creatinine and bilirubin was used to calculate the MELD-XI score. Lowess smoothing plots were referenced, and a score threshold of 12.2 was used to stratify patients into low (75%) and high (25%) MELD-XI cohorts. Patient-specific characteristics, intraoperative variables, and postoperative outcomes were compared between the two cohorts. Differences in survival at 30 days, 1 year, and 5 years between the MELD-XI cohorts were estimated by the Kaplan-Meier method. Cox proportional hazards modeling was used to determine the risk-adjusted effect of a high MELD-XI score on death. After patients with missing MELD-XI scores were excluded, 2,939 patients met the inclusion criteria. Unconditional 30-day (93.1% vs 98.0%, p < 0.001), 1-year (85.9% vs 92.9%, p < 0.001), and 5-year (71.2% vs 79.5%, p < 0.001) survivals were signifi...Continue Reading

References

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Citations

Feb 1, 2017·Congenital Heart Disease·Moira B HilscherPatrick S Kamath
Jul 5, 2018·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Ana Claudia Oliveira de Moraes, Olival Cirilo Lucena da Fonseca-Neto
Apr 20, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Alexander LemmerDaniel Ganger
Apr 6, 2019·The American Journal of Surgical Pathology·Dustin E BoschMatthew M Yeh
Apr 28, 2020·Journal of Cardiac Surgery·Brian AyersIgor Gosev
Oct 1, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Getanshu MalikJennifer Conway
Aug 3, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Getanshu MalikJennifer Conway
May 11, 2020·Clinical Transplantation·Natalie L Y NguWilliam Kemp
Jan 2, 2018·Clinical Liver Disease·Alexander LemmerDaniel Ganger
May 16, 2019·World Journal for Pediatric & Congenital Heart Surgery·Charles D FraserLuca A Vricella
Mar 6, 2021·JHEP Reports : Innovation in Hepatology·Anna SessaJean-François Cadranel
Jul 2, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Angela LortsAntonio Amodeo
Aug 21, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·John C DykesUNKNOWN Pediatric Heart Transplant Society

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