The contribution of perioperative prognosis evaluation of patients underwent  living  donor liver transplantation with Acute Physiology and Chronic Health Evaluation II models and MELD        CHEN Rui, SHEN Chuan, WAN Liang,et al. Shanghai Institute of Digestive Surgery, Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025,China
.Corresponding Author: ZHOU Guang-wen, E-mail：gw_vrai@yahoo.com.cn
Abstract    Objective    To study the methods of evaluation of living donor liver transplantation(LDLT) perioperative prognosis by APACHE II models associated with MELD accurately. Methods    The clinical and laboratory data of 38 patients receiving LDLT in our hospital from June 2006 to May 2009 were retrospectively analyzed. Results    Mean（standard deviation [SD]）APACHE II score of survivors and non-survivors were 13.03 (3.47) and 23.67(3.27) respectively.Mean(SD) risk of death were 7.05%(3.70%) and 25.07%(9.34%) respectively.There was a magnificent difference in APACHE II score and risk of death between two groups(P＜0.001). APCHE models have more accuracy of evaluation after excluding the surgical interference. Mean(SD) predicted hospital mortality of patients with MELD＞25 and MELD＜25 were 7.10%(3.84%) and 15.11%(11.93%) respectively and have statistical discrepancy(P<0.05). APACHE II score and MELD in the ROC cutoff value was 20 and 25 respectively. Conclusions    Pay attention to preventing the surgical interference when prognosis evaluation of patients underwent LDLT with APACHE models.The modified APACHE II model can provide an closely accurate prognosis evaluation of patients performed LDLT.The predicted hospital mortality of the patients with APACHE II>20 or MELD>25 increase obviously.