P45 Preoperative D-MELD and D-UKELD scores as predictors of survival after liver transplant

Introduction D-MELD score, the product of donor age and preoperative MELD score, has been introduced as a potential predictive index of survival after othrotopic liver transplant (OLT). We created D-UKELD score, the product of donor age and preoperative UKELD score, estimated its role as a predictor of graft and patient survival post OLT and compared it with D-MELD score. Methods We included 849 OLTs from donation after brain death (DBD) in our analysis (January 2008 – Novemeber 2019). Data were collected concerning donor and recipient characteristics, and transplant characteristics and outcomes. D-MELD and D-UKELD scores were also calculated. Results Time-dependent receiver operating characteristic (ROC) analysis did not provide statistically significant area under the curve (AUC) at 1, 3 or 5 years post OLT concerning graft survival for either D-MELD or D-UKELD. It also did not yield. statistically significant AUC at 3 or 5 years post OLT regarding patient survival. However, AUC was statistically significant, although mediocre, at 1 year after OLT concerning patient survival for D-MELD (AUC: 0.615, 95% CI: 0.543–0.688) and D-UKELD (AUC: 0.594, 95% CI: 0.527–0.662). The optimal cut-off points from the ROC curves at 1 year after OLT were D-MELD>1012 and D-UKELD>2640 regarding patient survival. Recipients with D-MELD>1012 had worse patient survival within the first year (p=0.00006), which remained in the multivariable analysis (HR: 1.917, 95% CI: 1.06–3.465, p=0.031). Recipients with D-UKELD>2640 had worse patient survival within the first year as well (p=0.006), but this did not remain in the multivariable analysis (HR: 1.724, 95% CI: 0.952–3.121, p=0.072). Conclusions D-MELD and D-UKELD scores have mediocre predictive ability in regards to 1-year patient survival post DBD OLT. D-MELD>1012 is independently associated with an almost double risk of death within the first year, but D-UKLED is not independently related to worse recipient survival.