Short-term clinical efficacy of liver transplantation with organs from donation after Chinese citizens' death in patients with high model for end-stage liver disease score

  Objective  To explore the short-term clinical efficacy and safety after liver transplantation with organs from Chinese donation after citizens' death in patients with high model for end-stage liver disease (MELD) score.

  Methods  The clinical data of 34 liver transplantation recipients with organs from donation after citizens' death from November 2011 to June 2014 in the First People's Hospital of Foshan were retrospectively analyzed. All recipients were divided into the high MELD score (MELD score≥25, n=8) and low MELD score groups (MELD score < 25, n=26) according to preoperative MELD score. Preoperative, intraoperative and postoperative status of the patients was statistically compared between two groups.

  Results  Prior to operation, the proportion of patients requiring artificial liver support and the incidence of acute or chronic and acute liver failure in the high MELD score group were significantly higher than those in the low MELD score group (all in P < 0.05). Intraoperatively, there was no significant difference in blood loss, perfusion volume, warm and cold ischemia time, anhepatic period, operative time and approach between two groups (all in P > 0.05). After operation, the length of intensive care unit (ICU) stay in the high MELD score group was significantly longer than that in the low MELD score group (P < 0.05). And there was no significant difference in the length of hospital stay, mortality during hospitalization, incidence of early complications, follow-up time and overall survival rate between two groups (all in P > 0.05). The peak level of aspartate aminotransferase (AST) in the high MELD score group was significantly higher compared with that in the low MELD score group (P < 0.05). The incidence of bile leakage, abdominal abscess and liver dysfunction significantly differed between two groups (all in P < 0.05).

  Conclusions  It is a safe and short-term efficacious approach to perform liver transplantation with organs obtained from Chinese donation after citizens' death in patients with high MELD score liver recipients.