MELD 3.0 Not Associated With Survival After Combined Heart–Liver Transplantation

An observational analysis published in Clinical Transplantation evaluated whether MELD 3.0 predicts outcomes after combined heart–liver transplantation. Investigators identified 601 adult recipients in the United Network for Organ Sharing database between March 2005 and May 2025. MELD 3.0 scores at transplantation were classified as low (1–14; n=231), medium (15–24; n=314), or high (≥25; n=56). Outcomes included overall survival and freedom from liver graft failure.

Kaplan–Meier analyses found no statistically significant differences across groups in survival or liver graft failure (both p=0.22). One-year survival was 82.6%, 82.6%, and 90.2% in the low, medium, and high groups, respectively; five-year survival was 73.8%, 76.9%, and 82.0%. MELD 3.0 was not associated with mortality in Cox analysis (hazard ratio 0.98; p=0.144). The authors reported that mortality risk was greatest during the first year in all groups.

These findings suggest that an elevated MELD 3.0 score alone may have limited value for predicting post-transplant outcomes in appropriately selected combined heart–liver recipients. However, the observational design, restriction to patients who received transplantation, and small high-score group limit interpretation. Nonsignificant differences do not establish equivalent outcomes. Only the abstract was available, limiting assessment of adjustment methods and other study details.