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Infectious Complications in the Era of MELD

Benjamin Juntermanns, Paul Manka, Dieter Paul Hoyer, Gernot Maximillian Kaiser, Sonia Radunz, Wolfgang Pracht, Zoltan Mathé, Peter-Michael Rath, Jörg Steinmann, Jürgen Walter Treckmann, Maren Schulze

(Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany)

Ann Transplant 2015; 20:297-302

DOI: 10.12659/AOT.893122

BACKGROUND: Infections are a major cause for morbidity and mortality in liver transplant recipients. So far there has been no study systematically investigating the correlation between the MELD (Model for End-Stage Liver Disease) scoring system and complications caused by infections. The aim of the present retrospective study was to evaluate the impact of the pretransplant MELD score on incidence and mortality of pneumonia and septicemia in liver transplant recipients.
MATERIAL AND METHODS: The clinical courses of 201 liver transplant recipients between 12/2006 and 3/2009 were recorded and analyzed on the basis of chart review. Patients were stratified into three groups (pretransplant MELD score: group I 6–20, group II ≥21–30, group III ≥31–40) and compared in terms of incidence of infection and survival.
RESULTS: The mean pretransplant MELD score was 22±12. There were 81 patients in group I, 65 patients in group II, and 55 patients in group III. There was no difference in incidence of infections between the MELD groups. However, septicemia-associated mortality was significantly higher in group III.
CONCLUSIONS: A high MELD score is not associated with higher incidence of infections but it is associated with a significantly higher mortality in the case of septicemia. Prevention of infections is of utmost importance, especially in liver transplant recipients with high MELD scores.

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