Peak-MELD scores, a disease trajectory associated with reduced access to liver transplantation
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By
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Paul Jamme
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Julian Allgeier
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Dionysios Koliogiannis
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Markus Guba
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Christian M. Lange
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June 26, 2026
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Objective:
To investigate the association between peak-MELD scores and liver transplantation outcomes in patients with liver cirrhosis.
Approach:
- Study Design: A retrospective analysis of 109 patients listed for liver transplantation at LMU University Hospital from 2019 to 2022.
- MELD Score Definition: Peak-MELD scores were defined as a transient increase of at least five MELD points within 1 month.
- Statistical Analysis: Statistical analyses included unpaired t-tests, Mann-Whitney U tests, Fisher’s exact test, and Cox proportional hazards models.
Key Findings:
- 11% of patients experienced a peak-MELD trajectory.
- Patients with peak-MELD scores had a significantly lower transplantation rate (HR = 0.37; 95% CI [0.15, 0.92]; p = 0.03).
- Patients with peak-MELD scores had a longer median waiting time for transplantation (377 vs. 85 days).
- Infections were the predominant cause of waitlist status changes.
Interpretation:
Limitations:
- The study was conducted at a single center with a small sample size.
- Further multicenter studies are needed to validate findings.
Conclusion:
