Model for end-stage liver disease-sodium and survival benefit in liver transplantation

Transpl Int. 2013 Feb;26(2):138-44. doi: 10.1111/tri.12008. Epub 2012 Nov 29.


There are currently no studies calculating the survival benefit of liver transplantation (LT) according to model for end-stage liver disease-sodium (MELD-Na) and based on the competing risk (CR) method. We enrolled consecutive adult patients with chronic end-stage liver disease entering the waiting list (WL) for primary LT (WL group = 337) and undergoing LT (LT group = 220) in the period 2006-2009. Two independent multivariable regressions (WL and LT models) were created to measure the prognostic power of MELD-Na with respect to MELD. For the WL model, both Cox and CR multivariable analyses were performed. Estimates were finally included in a Markov model to calculate 3-year survival benefit. WL Cox model: MELD-Na (P < 0.0001) and MELD (P < 0.0001) significantly predicted survival. WL CR model: MELD-Na (P = 0.0045) and MELD (P = 0.0109) significantly predicted survival. LT Cox model: MELD-Na (P = 0.7608) and MELD score (P = 0.9413) had not correlation with survival. Benefit model: MELD and MELD-Na had an overlapping significant impact on 3-year survival benefit; CR method determined a significant decrease in 3-year life expectancy (LE) estimations. MELD-Na and MELD scores similarly predicted 3-year LT survival benefit, but the gain in LE is significantly lower when a CR method is adopted.

MeSH terms

  • End Stage Liver Disease / blood*
  • End Stage Liver Disease / diagnosis
  • End Stage Liver Disease / therapy*
  • Female
  • Humans
  • Liver Transplantation*
  • Male
  • Markov Chains
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Regression Analysis
  • Severity of Illness Index
  • Sodium / blood*
  • Time Factors
  • Tissue and Organ Procurement
  • Treatment Outcome
  • Waiting Lists


  • Sodium