MELD Score Before and After Plasmapheresis in Recipients of ABO-Incompatible Living Donor Liver Transplantation

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-04-30 DOI:10.1016/j.transproceed.2025.03.017

Ja Eun Lee, Sooyeon Lee, Justin Sangwook Ko, Mi Sook Gwak, Gaab Soo Kim

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引用次数: 0

Abstract

Background

In ABO-incompatible living donor liver transplantation (LDLT), many strategies including plasmapheresis have been introduced to overcome the ABO blood group barrier. After plasmapheresis, the MELD score can change because the levels of its three components [international normalized ratio (INR), total bilirubin (Tb), and creatinine (Cr)] may be affected.

Method

Present study included 142 recipients of ABO-incompatible LDLT. MELD score was calculated according to the original formula [11.2 ln (INR) + 3.78 ln (Tb) + 9.56 ln (Cr) + 6.43]. We compared the MELD score and the three components of the MELD score before and after plasmapheresis.

Results

In the entire cohort, MELD score decreased from 13 to 11 after plasmapheresis. MELD score increased in 41 (28.9%), maintained in 25 (17.6%), and decreased in 76 (53.5%) recipients. The change of INR, Tb, and Cr was mostly in the same direction as the change of MELD score.

Conclusion

MELD scores of ABO-incompatible LDLT recipients mostly change after plasmapheresis. Decline in MELD score was most common, followed by rise and maintenance.

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abo血型不相容活体肝移植患者血浆置换前后MELD评分。

背景：在ABO血型不相容的活体肝移植（LDLT）中，包括血浆置换在内的许多策略已被引入以克服ABO血型屏障。血浆置换后，MELD评分可能发生变化，因为其三个组成部分[国际标准化比值（INR）、总胆红素（Tb）和肌酐（Cr）]的水平可能受到影响。方法：本研究纳入142例abo血型不相容的LDLT受体。MELD评分按原公式[11.2 ln (INR) + 3.78 ln (Tb) + 9.56 ln (Cr) + 6.43]计算。我们比较血浆置换前后MELD评分和MELD评分的三个组成部分。结果：在整个队列中，血浆置换后MELD评分从13降至11。MELD评分上升41例（28.9%），维持25例（17.6%），下降76例（53.5%）。INR、Tb、Cr的变化与MELD评分的变化方向基本一致。结论：血浆置换后abo血型不相容的LDLT受体MELD评分变化较多。MELD评分最常见的是下降，其次是上升和维持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.