The concordance statistic did not find significance between UNOS status and MELD score for 3-month patient ( P = 0.283) or graft mortality ( P = 0.957), although the MELD score revealed a major sensitivity for short-term patient mortality (0.637 95%CI: 0.513–0.75). The 3-month patient and graft mortality was 15.94% and 20.29% respectively. The inter-rate agreement between UNOS status and MELD score after categorization for clinical urgency showed a fair agreement (κ = 0.244). No significant difference occurred in the median MELD score between patients who underwent a second LT and those who did not ( P =0.458). Through univariate Cox regression, pretransplantation international normalized ratio ( P = 0.049) and activated partial thromboplastin time ( P = 0.032) were significantly associated with 3-month patient survival, although not in the subsequent multivariate analysis.
No donor-related parameters affected 3-month patient survival. Sixty-nine patients listed at UNOS status 3 ( n = 5), 2B ( n = 55) or 2A ( n = 9) who underwent LT were enrolled according to strict criteria. In the present study we investigated the predictive value of the MELD score for short-term patient and graft mortality in comparison with conventional UNOS status. However, the accuracy of the MELD model to predict post-transplantation outcome is fairly elusive. In the early 2002, United Network for Organ Sharing (UNOS) has proposed to replace the conventional statuses 3, 2B, and 2A with a modified MELD score. The Model for End-stage Liver Disease (MELD) provides a score able to predict short-term mortality in patients awaiting liver transplantation (LT).
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