Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Colégio Brasileiro de Cirurgiões |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912021000100239 |
Resumo: | ABSTRACT Objective: to correlate clinical and epidemiological data with the pathological analysis of liver explants from patients undergoing liver transplantation for hetapocarcinoma in the UNICAMP HC and to verify whether the MELD and MELD-Na scores are reliable factors to predict a worse post-transplant prognosis. Methods: we studied liver transplants carried out between May 2010 and November 2017. After excluding 38 patients, we included 87, analyzing clinical and laboratory data for correlation with the outcome Microvascular Invasion (MVI). Subsequently, we computed the MELD and MELD-Na scores and performed a descriptive analysis of clinical and laboratory data and, finally, calculated ROC curves to assess the association between these laboratory parameters and mortality in these patients. Results: most patients were male (78.30%), with an average age of 58.53 years. Most liver diseases were caused by HCV (53.26%). We found no predictors for MVI among the laboratory parameters. The ROC curves for death identified the MELD score as the cutoff point with the highest combined sensitivity (90.91%) and specificity (37.50%), with a value of 10 points, whereas in the MELD-Na the cutoff point was 7 points, with a sensitivity of 90.91% and a specificity of 33.33%, both scores being significant. Conclusions: there were no reliable predictors of MVI between clinical, laboratory, and epidemiological variables. The MELD-Na score is more sensitive than the MELD one for predicting mortality in patients undergoing liver transplantation. |
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Revista do Colégio Brasileiro de Cirurgiões |
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Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantationLiver NeoplasmsHepatic CirrhosisLiver transplantABSTRACT Objective: to correlate clinical and epidemiological data with the pathological analysis of liver explants from patients undergoing liver transplantation for hetapocarcinoma in the UNICAMP HC and to verify whether the MELD and MELD-Na scores are reliable factors to predict a worse post-transplant prognosis. Methods: we studied liver transplants carried out between May 2010 and November 2017. After excluding 38 patients, we included 87, analyzing clinical and laboratory data for correlation with the outcome Microvascular Invasion (MVI). Subsequently, we computed the MELD and MELD-Na scores and performed a descriptive analysis of clinical and laboratory data and, finally, calculated ROC curves to assess the association between these laboratory parameters and mortality in these patients. Results: most patients were male (78.30%), with an average age of 58.53 years. Most liver diseases were caused by HCV (53.26%). We found no predictors for MVI among the laboratory parameters. The ROC curves for death identified the MELD score as the cutoff point with the highest combined sensitivity (90.91%) and specificity (37.50%), with a value of 10 points, whereas in the MELD-Na the cutoff point was 7 points, with a sensitivity of 90.91% and a specificity of 33.33%, both scores being significant. Conclusions: there were no reliable predictors of MVI between clinical, laboratory, and epidemiological variables. The MELD-Na score is more sensitive than the MELD one for predicting mortality in patients undergoing liver transplantation.Colégio Brasileiro de Cirurgiões2021-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912021000100239Revista do Colégio Brasileiro de Cirurgiões v.48 2021reponame:Revista do Colégio Brasileiro de Cirurgiõesinstname:Colégio Brasileiro de Cirurgiões (CBC)instacron:CBC10.1590/0100-6991e-20212997info:eu-repo/semantics/openAccessBARBOSA,BRAINNER CAMPOSSANTOS,LEANDRO AUGUSTO RODRIGUESDAHER,GUSTAVO HENRIQUE RASSI MAHAMEDMARTINS,DANIEL LAHANPERALES,SIMONE REGESGALLANI,STEPHANIS KILARISCOSTA,LARISSA BASTOS ELOY DALAGO,EDUARDO ANDREAZZA DALBOIN,IIKA DE FÁTIMA SANTANTA FERREIRACASERTA,NELSON MARCIO GOMESATAÍDE,ELAINE CRISTINA DEeng2022-02-02T00:00:00Zoai:scielo:S0100-69912021000100239Revistahttp://www.scielo.br/rcbcONGhttps://old.scielo.br/oai/scielo-oai.php||revistacbc@cbc.org.br1809-45460100-6991opendoar:2022-02-02T00:00Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC)false |
dc.title.none.fl_str_mv |
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation |
title |
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation |
spellingShingle |
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation BARBOSA,BRAINNER CAMPOS Liver Neoplasms Hepatic Cirrhosis Liver transplant |
title_short |
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation |
title_full |
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation |
title_fullStr |
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation |
title_full_unstemmed |
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation |
title_sort |
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation |
author |
BARBOSA,BRAINNER CAMPOS |
author_facet |
BARBOSA,BRAINNER CAMPOS SANTOS,LEANDRO AUGUSTO RODRIGUES DAHER,GUSTAVO HENRIQUE RASSI MAHAMED MARTINS,DANIEL LAHAN PERALES,SIMONE REGES GALLANI,STEPHANIS KILARIS COSTA,LARISSA BASTOS ELOY DA LAGO,EDUARDO ANDREAZZA DAL BOIN,IIKA DE FÁTIMA SANTANTA FERREIRA CASERTA,NELSON MARCIO GOMES ATAÍDE,ELAINE CRISTINA DE |
author_role |
author |
author2 |
SANTOS,LEANDRO AUGUSTO RODRIGUES DAHER,GUSTAVO HENRIQUE RASSI MAHAMED MARTINS,DANIEL LAHAN PERALES,SIMONE REGES GALLANI,STEPHANIS KILARIS COSTA,LARISSA BASTOS ELOY DA LAGO,EDUARDO ANDREAZZA DAL BOIN,IIKA DE FÁTIMA SANTANTA FERREIRA CASERTA,NELSON MARCIO GOMES ATAÍDE,ELAINE CRISTINA DE |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
BARBOSA,BRAINNER CAMPOS SANTOS,LEANDRO AUGUSTO RODRIGUES DAHER,GUSTAVO HENRIQUE RASSI MAHAMED MARTINS,DANIEL LAHAN PERALES,SIMONE REGES GALLANI,STEPHANIS KILARIS COSTA,LARISSA BASTOS ELOY DA LAGO,EDUARDO ANDREAZZA DAL BOIN,IIKA DE FÁTIMA SANTANTA FERREIRA CASERTA,NELSON MARCIO GOMES ATAÍDE,ELAINE CRISTINA DE |
dc.subject.por.fl_str_mv |
Liver Neoplasms Hepatic Cirrhosis Liver transplant |
topic |
Liver Neoplasms Hepatic Cirrhosis Liver transplant |
description |
ABSTRACT Objective: to correlate clinical and epidemiological data with the pathological analysis of liver explants from patients undergoing liver transplantation for hetapocarcinoma in the UNICAMP HC and to verify whether the MELD and MELD-Na scores are reliable factors to predict a worse post-transplant prognosis. Methods: we studied liver transplants carried out between May 2010 and November 2017. After excluding 38 patients, we included 87, analyzing clinical and laboratory data for correlation with the outcome Microvascular Invasion (MVI). Subsequently, we computed the MELD and MELD-Na scores and performed a descriptive analysis of clinical and laboratory data and, finally, calculated ROC curves to assess the association between these laboratory parameters and mortality in these patients. Results: most patients were male (78.30%), with an average age of 58.53 years. Most liver diseases were caused by HCV (53.26%). We found no predictors for MVI among the laboratory parameters. The ROC curves for death identified the MELD score as the cutoff point with the highest combined sensitivity (90.91%) and specificity (37.50%), with a value of 10 points, whereas in the MELD-Na the cutoff point was 7 points, with a sensitivity of 90.91% and a specificity of 33.33%, both scores being significant. Conclusions: there were no reliable predictors of MVI between clinical, laboratory, and epidemiological variables. The MELD-Na score is more sensitive than the MELD one for predicting mortality in patients undergoing liver transplantation. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912021000100239 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912021000100239 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0100-6991e-20212997 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
dc.source.none.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões v.48 2021 reponame:Revista do Colégio Brasileiro de Cirurgiões instname:Colégio Brasileiro de Cirurgiões (CBC) instacron:CBC |
instname_str |
Colégio Brasileiro de Cirurgiões (CBC) |
instacron_str |
CBC |
institution |
CBC |
reponame_str |
Revista do Colégio Brasileiro de Cirurgiões |
collection |
Revista do Colégio Brasileiro de Cirurgiões |
repository.name.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC) |
repository.mail.fl_str_mv |
||revistacbc@cbc.org.br |
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1754209215374688256 |