LDLT for High MELD Recipients: A Single Center Experience

There is an ever-growing organ shortage in the United States that corresponds with an enormous disparity between supply and demand of livers available for liver transplantation. A recent study by UPMC physicians Swaytha Ganesh, MD, Michele Molinari, MD, Amit Tevar, MD, Christopher Hughes, MD, and Abhinav Humar, MD, focuses on living-donor liver transplantation and its underutilization in high Model For End-Stage Liver Disease (MELD) patients ( MELD ≥ 25). The main objectives of this research, which will be presented at the 2018 American Transplant Congress (ATC), include:

• Assessing the impact of pre-transplant high MELD score on short-term post-transplant outcomes in LDLT recipients at UPMC Transplant Services 

• Analyzing the effect of pre-transplant Model for End-stage Liver Disease (MELD) score on outcomes following LDLT 

• The primary end point was graft and patient survival at three months and one year

The results of the study, which include findings that the graft rate recipient ratio (GWRW) was significantly lower in the MELD<25 group compared to the MELD ≥ 25 group (p<0.001), have led to discussions supporting the notion that LDLT is a safe, viable and good option, even in high MELD recipients.

The research supports the findings that living-donor liver transplant for high MELD patients will help to decrease waiting list mortality and increase transplant rates. At UPMC, living-donor liver transplant is discussed as a viable option for all patients that can benefit from a liver transplant. According to research outcomes, this option is effective, timely, and leads to increased survival rates. UPMC physicians believe that “It is time to switch the paradigm and change the equation favorable toward the recipients to reduce the waiting list mortality.”