Comparison of MELD, MELD-Na, and MELD 3.0 scoring systems for transplant prioritization in the turkish population: A multicenter study

The Model for End-Stage Liver Disease Sodium (MELD-Na) score predicts mortality in liver transplant candidates. MELD 3.0 has been proposed as an improved model for estimating mortality risk. This study evaluated MELD 3.0's predictive accuracy for short-term mortality among Turkish liver transplant candidates and compared its performance with MELD and MELD-Na scores. Patients listed both for deceased donor transplants and living donor transplants were analyzed in the study. The discriminative abilities of MELD, MELD-Na, and MELD 3.0 scores were assessed using the area under the receiver operating characteristic curve (AUROC). Comparisons between AUROC values used DeLong's test. The most predictive cut off for MELD 3.0 was determined using Youden's index. Transplant-free survival was analyzed using the Kaplan-Meier method, with survival curves compared using the log-rank test. A total of 1,689 patients were included in this nationwide, multicenter study. Hepatitis B was the leading cause of cirrhosis (29%, n=491), followed by metabolic-associated steatohepatitis (20%, n=335). For 3-month mortality, MELD 3.0 had the highest AUROC (0.753), followed by MELD-Na (0.747) and MELD (0.725). The most predictive cut off values were 18 for MELD and 21 for MELD-Na and MELD 3.0. Both MELD-Na and MELD 3.0 outperformed MELD (p<0.001), but showed no significant difference between them (p=0.17). MELD 3.0 and MELD-Na demonstrated superior performance to MELD in predicting 3-month mortality among Turkish liver transplant candidates, though their predictive accuracy was comparable. Further refinements are needed to enhance MELD 3.0's clinical utility.

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Publication Details

Journal
Liver Transplantation
Published
2026-04-13
DOI
https://doi.org/10.1097/lvt.0000000000000863
Primary Topic
Liver Disease and Transplantation
Type
article
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article

Comparison of MELD, MELD-Na, and MELD 3.0 scoring systems for transplant prioritization in the turkish population: A multicenter study

Ahmet UYANIKOĞLU, İlker Turan, Haydar Adanır, Murat Dayangaç et al.
Liver Transplantation
Liver Disease and Transplantation
article

Comparison of MELD, MELD-Na, and MELD 3.0 scoring systems for transplant prioritization in the turkish population: A multicenter study

Ahmet UYANIKOĞLU, İlker Turan, Haydar Adanır, Murat Dayangaç, Mehmet Akif Yağli, Dilara Turan Gökçe, Murat Akyıldız, Hale Gökcan, Mehmet Refik Goktug, Ramazan Idılman, Mesut Akarsu, Murat Kekilli, Efe Erbay, Amir Salar Nazari, Onur Keskın, Meral Akdoğan Kayhan, Murat M. M. Harputluoglu, Derya Arı, Gupse Adalı, Kenan Moral, Mehmet Cindoruk, Zeki Karasu, Osman Yüksekyayla, Şencan Acar, Tarkan Karakan, Baver Ordu, Fatih Eren, Burcu Gürbüz, Gulsah Fidan Ozkumur, Gokhan Kabacam, N Yilmaz, Fulya Günşar, Zeynep Melekoglu Ellik, Genco Gencdal, Murat Kıyıcı, Sabahattin Kaymakoğlu, Alper Akın, Elvan Işık, Sezai Yilmaz, Nilay Danış, Doğancan Gavcar
article en

Abstract

The Model for End-Stage Liver Disease Sodium (MELD-Na) score predicts mortality in liver transplant candidates. MELD 3.0 has been proposed as an improved model for estimating mortality risk. This study evaluated MELD 3.0's predictive accuracy for short-term mortality among Turkish liver transplant candidates and compared its performance with MELD and MELD-Na scores. Patients listed both for deceased donor transplants and living donor transplants were analyzed in the study. The discriminative abilities of MELD, MELD-Na, and MELD 3.0 scores were assessed using the area under the receiver operating characteristic curve (AUROC). Comparisons between AUROC values used DeLong's test. The most predictive cut off for MELD 3.0 was determined using Youden's index. Transplant-free survival was analyzed using the Kaplan-Meier method, with survival curves compared using the log-rank test. A total of 1,689 patients were included in this nationwide, multicenter study. Hepatitis B was the leading cause of cirrhosis (29%, n=491), followed by metabolic-associated steatohepatitis (20%, n=335). For 3-month mortality, MELD 3.0 had the highest AUROC (0.753), followed by MELD-Na (0.747) and MELD (0.725). The most predictive cut off values were 18 for MELD and 21 for MELD-Na and MELD 3.0. Both MELD-Na and MELD 3.0 outperformed MELD (p<0.001), but showed no significant difference between them (p=0.17). MELD 3.0 and MELD-Na demonstrated superior performance to MELD in predicting 3-month mortality among Turkish liver transplant candidates, though their predictive accuracy was comparable. Further refinements are needed to enhance MELD 3.0's clinical utility.

Liver Transplantation
Bursa Uludağ Üni̇versi̇tesi̇ (TR), Koç University (TR), Ankara University (TR), Bilkent University (TR), Dokuz Eylül University (TR), Akdeniz University (TR), Inonu University (TR), Istanbul Medipol University (TR), Ege University (TR), Akdeniz University Hospital (TR), Ümraniye Eğitim ve Araştırma Hastanesi (TR), Güven Hospital (TR), Gazi Hastanesi (TR), Başkent University Hospital (TR), Sanko University (TR), Nightingale Hospital (IN), Hacettepe University (TR), Istanbul University (TR), Harran University (TR), Gazi University (TR)
Reduced inequalities
Openalex Percentile: Top 32%
Liver Disease and Transplantation
DOISourceOpenAlex
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