Survival tree and meld to predict long term survival in liver transplantation waiting list

TL;DR

This study evaluates the effectiveness of the MELD score and other variables in predicting long-term mortality among liver transplant waiting list patients using a novel survival tree analysis.

Contribution

It introduces a survival tree model to assess long-term mortality prediction, confirming the clinical MELD cutoff of 16 as significant.

Findings

MELD score at 16 is a key cutoff for long-term mortality prediction.

Survival tree analysis effectively identifies significant predictors.

Results support existing clinical MELD cutoff for long-term prognosis.

Abstract

Background: Many authors have described MELD as a predictor of short-term mortality in the liver transplantation waiting list. However MELD score accuracy to predict long term mortality has not been statistically evaluated. Objective: The aim of this study is to analyze the MELD score as well as other variables as a predictor of long-term mortality using a new model: the Survival Tree analysis. Study Design and Setting: The variables obtained at the time of liver transplantation list enrollment and considered in this study are: sex, age, blood type, body mass index, etiology of liver disease, hepatocellular carcinoma, waiting time for transplant and MELD. Mortality on the waiting list is the outcome. Exclusion, transplantation or still in the transplantation list at the end of the study are censored data. Results: The graphical representation of the survival trees showed that the most statistically significant cut off is related to MELD score at point 16. Conclusion: The results are compatible with the cut off point of MELD indicated in the clinical literature.