To discuss clinical value of the model for end-stage liver disease (MELD) and MELD-Na scores for predicting the short-term prognosis of liver transplantation in patients with liver failure.

The preoperative and intraoperative clinical data of 86 liver failure patients who underwent liver transplantation in the 900 Hospital of the Joint Logistics Team from January 2012 to December 2019 were collected in this retrospective analysis. Multivariate analysis were used to determine the risk factors of early death (within 3 months) after liver transplantation. The distinguishing ability of MELD and MELD-Na scores for early prognosis was evaluated by the receiver operating characteristic (ROC) curve, and the Youden index was used to determine the best cut-off value.

Of the 86 patients, there were 21 patients (24.4%) of early death in the short-term after liver transplantation. Preoperative MELD score (P=0.001) and intraoperative blood transfusion volume (P<0.001) were independent risk factors of liver transplantation in patients with liver failure. The AUC of MELD and MELD-Na scores for predicting the short-term prognosis were 0.696 and 0.686 respectively, with no statistical significancebetween two AUCs (P=0.677). The early survival rates of MELD≥24.3 group and MELD<24.3 group were 51.7% (15/29) and 87.7% (50/57), respectively (P<0.001). The early survival rates of MELD-Na≥25.7 groupand MELD-Na < 25.7 group were 54.9% (17/31) and 87.3% (48/55), respectively (both P<0.001). When the MELD score and MELD-Na score increased, the mortality rate increased.

In predicting the early prognosis of liver failure patients undergoing liver transplantation, there is no significant difference between the MELD score and the MELD-Na score in predicting ability. MELD score and intraoperative blood transfusion are independent risk factors for early death.