Longitudinal assessment of pre-transplant mortality risk among HIV-infected and uninfected patients with end-stage liver disease: the role of delta-meld score

The need for liver transplantation (LTx) has recently increased due to higher rates of end-stage liver disease (ESLD) associated with hepatitis C virus co-infection. Hence, LTx is now considered a definitive therapeutic option for selected HIV-positive patients. The model for ESLD (MELD) scoring system is the prevailing criterion for organ allocation, but its reliability has not been fully established in HIV-infected patients. Moreover, the change in MELDscore over time (Delta-MELD) may be a more accurate predictor of adverse outcomes in this population. The primary objective was to assess the role of Delta-MELD score as indipendent predictor of pre-transplant mortality in HIV-infected LTx candidates. The secondary objective was to determine factors associated with predictors of pre-transplant mortality in this population.