The areas under the curve (AUROC) for CPT score (0.46) and MELD (0.55) offered limited clinical utility compared to ICG clearance (0.78). Multivariate analysis was used to control Hydroxychloroquine for duration of surgery and weight of resected liver; 13CMBT was strongly associated with post-operative decompensation (R=0.68*). Conclusions: 13CMBT, FibroScan and ICG clearance correlated with laboratory measures
of liver function. ICG clearance and 13CMBT were superior to routine blood tests, CPT and MELD scores in predicting hepatic decompensation after liver resection. This result justifies further evaluation in other cohorts and clinical settings. Disclosures: The following people have nothing to disclose: James A. Thomas, Ashok S. Raj, Uthayanan Chelvaratnam, Marrianne Black, Caroline Tallis, Linda Fletcher, Gerald Holtmann, Jonathan Fawcett, Katherine Stuart Background: Although the Model for End-stage Liver Disease (MELD) score predicts liver transplantation waitlist survival, there is uncertainty surrounding what upper limit MELD score should be used to disqualify patients as too sick for living donor liver transplantation (LDLT). This uncertainty stems from the paucity of large studies evaluating the effect of MELD score on survival following LDLT. Aim: To evaluate the association
between MELD score and survival following LDLT in the U.S. population. Methods: All CHIR-99021 order U.S. adult LDLT recipients with MELD <25 were evaluated using the 2003-2012 United Network for Organ Sharing registry. Survival following LDLT was stratified into three MELD categories (MELD<15 vs. MELD 15-19 vs.
MELD 20-24) and evaluated using Kaplan Meier methods and multivariate Cox proportional hazards models. Results: Overall, 2,258 patients underwent LDLT, including 1,210 patients with MELD <15 (53.6%), 732 with MELD 15-19 (32.4%), and 316 with MELD 20-24 (14.0%). Compared to patients with MELD <15, there selleck compound was a significantly greater prevalence of ascites among those with MELD 15-19 (79.8% vs. 63.0%, p<0.001) and MELD 20-24 (82.0% vs. 63.0%, p<0.001). The same trend was seen for hepatic encephalopathy: MELD 15-19 (60.5% vs. 50.4%, p<0.001) and MELD 20-24 (63.9% vs. 50.4%, p<0.001). Compared to patients with MELD <15, overall 5-year survival following LDLT was similar among patients with MELD 15-19 (80.9% vs. 80.3%, p=0.77) and MELD 20-24 (81.2% vs. 80.3%, p=0.73) (Figure). When compared to patients with MELD <15, there was no significant difference in long-term post-LDLT survival among those with MELD 15-19 (HR 1.11, 95% CI, 0.85 – 1.45, p=0.45) and a non-significant trend towards lower survival in patients with MELD 20-24 (HR 1.28, 95% CI, 0.91 – 1.81, p=0.16). Conclusions: Among adult patients with chronic liver disease and MELD <25, higher MELD scores are not associated with significantly lower survival following LDLT. Disclosures: Aijaz Ahmed – Consulting: Bristol-Myers Squibb, Gilead Sciences Inc.