Preoperative characteristics and intraoperative transfusion and vasopressor requirements in patients with low vs. high MELD scores

Victor W. Xia, Bin Du, Michelle Braunfeld, Gundappa Neelakanta, Ke Qin Hu, Hamid Nourmand, Philip Levin, Ronald Enriquez, Jonathan R. Hiatt, R. Mark Ghobrial, Douglas G. Farmer, Ronald W. Busuttil, Randolph H. Steadman

Research output: Contribution to journalArticlepeer-review

75 Scopus citations

Abstract

Recent changes in organ allocation based on the model for end-stage liver disease (MELD) prioritize the most ill patients on the waiting list for liver transplantation. While patients undergoing liver transplantation in the MELD era are more acutely ill, the impact of the policy changes on perioperative management has not been completely assessed. We retrospectively reviewed the records of 124 primary adult liver transplant patients. Patients were divided into low (≤30) and high MELD (>30) score groups. Preoperative characteristics and intraoperative management were compared between the 2 groups. Patients with high MELD scores had lower baseline hematocrit and fibrinogen levels and were more likely to require ventilatory and vasopressor support before transplantation. Intraoperative transfusion requirements and use of vasopressors were also significantly increased in patients with high MELD scores compared to patients with low MELD scores. In conclusion, these data suggest that pretransplant MELD scores provide important information for perioperative management of patients undergoing liver transplantation.

Original languageEnglish (US)
Pages (from-to)614-620
Number of pages7
JournalLiver Transplantation
Volume12
Issue number4
DOIs
StatePublished - Apr 2006

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

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