• Elham Madreseh, Mahmood Mahmoudi, ToosiMohssen NassiriMNLiver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Jamileh Abolghasemi, and Hojjat Zeraati.
• Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
• J Res Med Sci. 2023 Jan 1; 28: 2828.

BackgroundDecompensated cirrhosis patients have a high risk of death which can be considerably reduced with liver transplantation (LT). This study aimed to simultaneously investigate the effect of some patients' characteristics on mortality among those with/without LT and also LT incident.Materials And MethodsIn this historical cohort study, the information from 780 eligible patients aged 18 years or older was analyzed by the Markov multistate model; they had been listed between 2008 and 2014, needed a single organ for initial orthotopic LT, and followed at least for up to 5 years.ResultsWith a median survival time of 6 (5-8) years, there were 275 (35%) deaths. From 255 (33%) patients who had LT, 55 (21%) subsequently died. Factors associated with a higher risk of mortality and LT occurrence were included: higher model for end-stage liver disease (MELD) score (hazard ratio [HR] = 1.16, confidence interval [CI]: 1.09-1.24 and HR = 1.22, CI: 1.41-1.30) and ascites complication (HR = 2.34, CI: 1.74-3.16 and HR = 11.43, CI: 8.64-15.12). Older age (HR = 1.03, CI: 1.01-1.06), higher creatinine (HR = 6.87, CI: 1.45-32.56), and autoimmune disease versus hepatitis (HR = 2.53, CI: 1.12-5.73) were associated with increased risk of mortality after LT.ConclusionThe MELD and ascites are influential factors on waiting list mortality and occurrence of LT. Total life expectancy is not influenced by higher MELD.Copyright: © 2023 Journal of Research in Medical Sciences.

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