Osseous metaplasia in a recurrent symptomatic rectal lesion: a rare occurrence.

BACKGROUND: Osseous metaplasia of the gastrointestinal tract is exceedingly rare. Associated with colorectal cancer, juvenile polyps , and inflammatory polyps, the exact etiology is still unknown. We present a case report on a young male with recurrent rectal polyps and rectal bleeding. Histopathology revealed an inflammatory polyp with focal osseous metaplasia. CASE PRESENTATION: A 30-year-old male without significant past medical history but with a significant smoking history of 10 pack-years. He initially presented to the colorectal clinic approximately 8 months prior with complaints of rectal pain and bleeding. The patient subsequently underwent colonoscopy which demonstrated a friable 2-cm mass at the dentate line. He was taken to the operating room for a transanal mass excision which, at the time, pathologic examination demonstrated a hyperplastic polyp with no evidence of dysplasia or malignancy. The patient returned to the clinic 8 months later with similar complaints of rectal bleeding. He denied any constitutional symptoms, weight loss, abdominal pain, diarrhea, or constipation. Upon rectal examination, he was noted to have a soft palpable mass blood on digital rectal exam. The patient was taken for repeat colonoscopy and was found to have a recurrent mass at the dentate line. Given the recurrent mass, the patient was taken for a re-excision in the operating room. Histopathology returned showing a 1.8 × 1.5 × 1.5 cm inflammatory polyp with focal osseous metaplasia. CONCLUSION: Osseous metaplasia of the gastrointestinal tract is a rare occurrence that can be associated with benign polyps or malignancy. Certain markers have been shown to be linked to this process and polypectomy remains the gold standard of treatment; however, further research is warranted.

Can the chlorophyll-a fluorescence be useful in identifying acclimated young plants from two populations of Cecropia pachystachya Trec. (Urticaceae), under elevated CO2 concentrations?

The physiological behavior of PSII measured by chlorophyll a fluorescence explains stress responses; wonders if it can differentiate plants from different populations. For this purpose, acclimated young plants of two C. pachystachya populations were cultivated from seeds. Chlorophyll-a fluorescence was measured after fertilization and [CO(2)](e). In the first 48 h after fertilization there was a reduction in the maximum quantum yield of PSII, while the means obtained under [CO(2)](e) were significantly higher than in other treatments (0.8 and 0.81). The variable PI best expressed the different conditions tested. Compared to their respective controls, the reduction of DIo/CS was 35.89 % in population (P) and 41.89 % in population (I), while the polyphasic fluorescence kinetics differed between treatments, but not necessarily between populations, except for post-fertilization at I-P steps. The analysis of kinetics between Fo and Fj (Wt) showed no K band during the O-J phase. The interferences found in PSII reinforces the idea of reversible damage to PSII. This effect is directly related to the reduced electron transport rate and increased non-photochemical dissipation and may be similar to those observed under field conditions after planting; adjustment time depends, among other factors, on the genetic potential of the species.

Fourier transform infrared photoacoustic spectroscopy as a potential tool in assessing the role of diet in cuticular chemical composition of Ectatomma brunneum.

The cuticular chemical composition plays a significant role in the recognition of nest mates in social insects, thus functioning as a chemical signature of the colony. The structure of cuticular chemicals is subject to interference from genetic and exogenous factors, including diet. In this study, various colonies of the Ectatomma brunneum ant were removed from their natural environment and housed in a laboratory to monitor the response of the cuticular chemical composition to dietary changes. Analyses were performed using gas chromatography and Fourier transform infrared photoacoustic spectroscopy, which has not been previously used for this type of analysis. The results indicate that this method is useful for analyzing biological and natural systems. We observed changes in the chemical signature with food traces in the first 30 days under feed control. Therefore, genetic information may not be the only criterion that can be used to describe the chemical signature of a species; environmental variations also influence recognition signals. Furthermore, these results reinforce the reliability of the Fourier transform infrared photoacoustic spectroscopy method.

Age-related changes in the surface pheromones of the wasp Mischocyttarus consimilis (Hymenoptera: Vespidae).

One of the most important attributes that allowed the evolution and maintenance of sociality in insects is their ability to distinguish members of their own colonies. The capacity for individual recognition in social insects is mediated by chemical signals that are acquired soon after the adult emerges, and vary according to the tasks performed by individuals in their colonies. We determined the time when adults of the wasp Mischocyttarus consimilis acquire the chemical signature of their colonies, as well as the variation in the cuticular hydrocarbon profiles of the exoskeleton of individuals, according to their functions in the colony. The method used was Fourier transform infrared photoacoustic spectroscopy directly on the gaster of each individual. Young wasps take three to four days to acquire the colony's chemical signature, with a small change on the fifth day, when the cuticular hydrocarbon profile of the workers is more similar to that of the queens than that of the males, probably because they are of the same sex, but primarily because of the similarity of tasks executed by these two groups of females in the colonies.

Distinct linear hydrocarbon profiles and chemical strategy of facultative parasitism among Mischocyttarus wasps.

Insects use pheromones as a means of chemical communication. Pheromones act on individual receptors and produce specific behavioral or physiological responses that are fundamental to intra- and interspecific recognition. The objective of this study was to evaluate the interspecific differences among the linear hydrocarbon profiles of the cuticles of 3 wasp species of the genus Mischocyttarus. The chemical strategy that permits an interaction among 2 of these species was also examined about their hydrocarbon profiles. The cuticular hydrocarbons present on the abdomen of each individual were extracted with hexane in an ultrasonic bath and analyzed using gas chromatography with a flame ionization detector. The results suggested that the wasp species have distinct chemical signatures as the linear hydrocarbons of their cuticles. However, these signatures are more alike in those with similar morphological and behavioral aspects. These similarities facilitate an interaction of facultative parasitism observed among these species, in which the invaders acquire parts of the chemical signature of the host colony, possibly as a chemical strategy to increase the likelihood that an invader will be accepted by the females of a host colony. Both invader and host have their own chemical signature changed by the first contact between the species.

Photoacoustic for thermal diffusivity determination of fish scale: A methodology for environmental integrity monitoring.

In this work the thermal diffusivity (D) of Astyanax lacustris fish scale is investigated aiming to use it for environmental integrity certification. The D values were obtained by a relatively simple procedure by a photoacoustic method. The chosen fish species is from wide occurrence in Brasil's basins. It has short migration, and it has also been used as environmental bioindicator. The results obtained in 195 scales sampled from three different streams in the Midwest region in Brazil gives an average value of D ~ 4 × 10-3 cm2/s. ANCOVA analysis demonstrated that D values are able to differentiate among the three basins and indicates that it is dependent on the scales thickness and water conductivity. This last one is strongly affected by biotic and abiotic actions, so that D values measured by photoacoustic method can be used for interpreting the environmental integrity from where the fishes were sampled.

Influence of urbanization on stream fish assemblages in three microbasins in the Upper Paraná River Basin.

The colonization pattern of fish assemblages in streams is often studied in the context of environmental filters. On the other hand, when fish assemblages are subjected to anthropogenic effects, variables associated with environmental quality assume more importance. Therefore, this work evaluated the richness and composition of fish from streams sampled at different urbanization levels, aiming to determine any direct effects on the structure of fish assemblages. To accomplish this, samples were collected from 2003 to 2011 at 31 sites distributed among 3 microbasins in the Rio Ivinhema Basin, Alto Rio Paraná. Based on environmental variables, physicochemical of the water and analysis of the use and occupation of the soil, the microbasins were classified into different urbanization levels (low, medium and high). A total of 4,320 individuals were sampled, out of which 57 fish species were recorded. Sampled sites with medium urbanization level presented higher richness compared to sampled sites with high urbanization level which presented lower richness. Species richness in these sites was explained mainly by water temperature and water velocity. Results confirmed that urbanization does directly affect environmental integrity, which, in turn, can lead to the homogenization of stream assemblages.

Reproduction of Hypoptopoma inexspectatum (Holmberg, 1893) (Siluriformes, Loricariidae) in the Southern Pantanal Floodplain, Upper Paraguay River Basin, Brazil.

This work aimed to describe the reproductive biology of Hypoptopoma inexspectatum in southern Pantanal. A total of 538 individuals were sampled and analyzed from February 2009 through January 2011 in southern Pantanal. We did not observe differences in sex-ratio, and both sexes presented positive allometric length/weight relationship (LWR). Reproduction occurs mainly from January to February. Females reached first maturation (L50) with 37.80 mm and males with 45.80 mm. Absolute fecundity is estimated in mean=177.43 (sd±127.06) oocytes and relative fecundity in 3.12 (sd±2.23) oocytes/mg. Fecundity is positively correlated with standard length (Spearman r= 0.43; p=0.013), and total spawning is a used spawning strategy for H. inexspectatum.

Effect of soluble corn fiber supplementation for 1 year on bone metabolism in children, the MetA-bone trial: Rationale and design.

Calcium intake is critical for adequate bone mineralization in adolescence, but it is usually inadequate in US adolescents. A strategy to maximize bone mineralization is to increase calcium absorption, which could be achieved by soluble corn fiber (SCF). There are no studies determining the long-term effects of SCF on bone mass in children. OBJECTIVES: To determine the effect of one-year SCF supplementation compared to placebo on bone mass and bone biomarkers in children with low habitual calcium intake. We hypothesize that SCF supplementation will result in a higher bone mineral content and higher levels of bone formation and lower bone resorption biomarkers. METHODS: 240 healthy children (10-13 years), with usual low calcium intake, will be randomized to four experimental groups for 1 year: (1) SCF (12 g/d); (2) SCF (12 g/d) + 600 mg/d of calcium; (3) Placebo (maltodextrin); and (4) Placebo +600 mg/d of calcium. The supplements have been pre-mixed with a flavored powder beverage and participants will only need to dilute it in water and drink this twice per day. Bone will be measured using dual energy x-ray absorptiometry (DXA) at baseline, 6 and 12 months. Serum bone biomarkers will be measured at baseline and at 12 months. CONCLUSIONS: If supplementing diets with SCF lead to higher bone mass during adolescence, this could help achieve the genetic potential for PBM and to start adult life with stronger bones. If successful, SCF can be incorporated into diets for promoting bone health in adolescents.

Reproductive ecology of Otocinclus vittatus (Regan, 1904) in the Pantanal floodplain, upper Paraguay River basin.

We studied the reproductive biology of Otocinclus vittatus in the southern Pantanal, Brazil. A total of 1066 fishes were analyzed (490 males, 488 females and 88 individuals of undetermined sex), sampled with a rectangular sieve and a seine net from February/2009 to January/2011. Variations in the sex ratio, seasonality in reproduction, fecundity, and size at first maturity were estimated. No variations were detected in the total sex ratio for the study period as a whole; although ratio has varied over time. The gonadosomatic index varied according to the river level, but not according to water temperature and rainfall. The mean fecundity was estimated at 84.1 oocytes, with a positive correlation with standard length. The size at first maturity (L50) estimated was 18.7 mm for females and 20.1 mm for males.

Reproductive biology of Hyphessobrycon eques (Characiformes: Characidae) in Southern Pantanal, Brazil.

Population and reproductive aspects allow the knowledge and understanding of population dynamics and the influence of environmental factors, in addition to ensure the success of a species continuity. Thus, the aim of this study was to analyze population and reproductive traits of the species Hyphessobrycon eques in southern Pantanal, Brazil. Monthly samplings were conducted from February/2009 to January/2011, with 617 individuals analyzed, being 365 females and 262 males. A similar form of distribution in length and weight between the sexes was observed. There was no significant variation in sex ratio over time, with higher proportion of females during the entire sampled period. Both sexes presented a angular coefficient of Weight/Length (b) relationship greater than 3, with speed of increase in weight greater than in length. For females, a long reproductive period was observed, with greater reproductive intensity from January through June. No significant correlation was observed between the Gonadosomatic Index (GSI) and the average temperature, rainfall and river level, despite the fact that reproductive activity occurs in autumn/winter, when there are favorable conditions due to flooding. The size at first maturation (L50) was 20.2 mm, with confidence interval varying from 19.7 through 20.7 mm. The average fecundity was 191.9 oocytes/females and was significantly related to the standard length and total weight (g), demonstrating a relation with energy accumulation to invest in reproduction. The long reproductive period, intensified by partial spawning, higher proportion of females and low L50, show that the species has strategies necessary for survival and rapid population growth, common in small species characterized as r-strategists.

Influence of Donor Obesity on Long-Term Liver Transplantation Outcomes.

OBJECTIVE: To analyze liver transplantation outcomes according to the body mass index (BMI) of donors. MATERIAL AND METHODS: A retrospective descriptive study was conducted in patients transplanted at our center between January 2006 and December 2014, comparing outcomes between grafts from obese (body mass index [BMI] ≥30) and nonobese (BMI ≤30) donors. We analyzed the reasons for transplantation, the morbidity-mortality related variables, and survival after a minimum follow-up of 24 months. A multivariate logistic model was constructed to predict the mortality. Survival was analyzed with the Kaplan-Meier method, and survival curves were compared using the log-rank test. RESULTS: The study included 50 obese and 175 nonobese donors. A significant difference between the groups was found in the pre-extraction intensive care unit (ICU) stay of the donors (P = .006) but not in the post-transplantation complications or survival of the respective recipients (P > .05). In the multivariate analysis, mortality was significantly associated with the presence of the hepatitis C virus (HCV) (P = .001) in the recipient and with the age of the donor (P = .043), finding the risk of death to be 2.87-fold higher in patients with HCV versus without HCV (95% confidence interval [1.641-5.043]) and 1.7% higher with every additional year of donor age (odds ratio 1.017, 95% confidence interval [1-1.034]). CONCLUSIONS: A significantly longer pre-extraction ICU stay was observed in obese (BMI ≥30) versus nonobese (BMI <30) donors, but no significant between-group difference was found in the post-transplant complications or survival of the respective recipients. The mortality risk was higher in HCV-positive recipients and in those receiving grafts from older donors.

Life-history traits of Farlowella hahni (Siluriformes, Loricariidae) in streams of the Ivinhema River Basin, Upper Paraná Basin.

Brazilian laws allow the catch of some species as ornamental fish; however, in the absence of biological information, such catch can threaten species conservation. Therefore, this study aimed to offer population and reproductive information about Farlowella hahni in streams of the Ivinhema River Basin, Upper Paraná Basin. To accomplish this, a total of 165 F. hahni individuals were analyzed, including 109 females and 48 males, resulting in an important sex ratio difference from 1:1 (χ 2=19.97; p<0.001), indicating a predominance of females throughout the year. Females reach higher standard length than males. Males presented isometric Length-Weight Relationships, while females have positive allometric growth. Gonadosomatic index presented higher values from October through December. The mean fecundity was 100.3±36.4 of vitellogenic oocytes and was positively correlated with standard length (r=0.51; p=0.01). The data presented herein are the first for this species and suggest a need to carefully manage the F. hahni population, considering its low abundance and fecundity.

Starting a new program of split liver transplantation after a low learning curve: a reality in centers with large experience in liver surgery and whole liver transplantation.

BACKGROUND/AIMS: Split liver transplantation (SLT) is nowadays, considered an adequate surgical solution to expand the grafts from the existing pool of cadaveric donors. METHODOLOGY: A total of 897 liver transplantations were performed between 1986 and 2002; 20 were SLTs (2.3%). A 30% were children. RESULTS: Mean follow up of 15.15 months +/- 13.85. Median age was 42.27 +/- 25.65 yrs. Median recipient weight was 52.29 +/- 20.87 Kg. Mean donor weight was 76.1 +/- 13.11. The majority was "in situ" SLT (65%). There was no primary graft dysfunction. Two patients developed biliary complications (none in situ SLT). Early HAT occurred in 2 patients and delayed HAT in one. Four patients were retransplanted but none were performed because of primary graft dysfunction. Five patients died in the hospital. Fifteen patients (75%) survived the postoperative period and 3 patients died during follow-up. Mean patient survival time was 42 months (95% CI: 31-52). Actuarial patient survival was 93.3%, 84.4%, 84.4% at 6 months, 1 year and 3 years. Mean graft survival was 36 months (95% CI: 25-48). Actuarial graft survival was 87%, 72%, 72% at 6, 12, 36 months. Univariate analysis of risk factors for graft loss showed that the type of splitting technique (p=0.019), and the UNOS (1 and 2a) status of the recipient (p=0.001) were significantly associated with graft loss. CONCLUSIONS: In the context of large volume full cadaveric liver transplantation, split liver can provide adequate results (even after a short learning curve) mainly in elective cases and with the in situ technique.

Intra- and interspecific variation of cuticular hydrocarbon composition in two Ectatomma species (Hymenoptera: Formicidae) based on Fourier transform infrared photoacoustic spectroscopy.

We have been able to discriminate different castes and sexes of ants in the same colony by measuring cuticular hydrocarbon levels with Fourier transform infrared photoacoustic spectroscopy, compared by canonical discriminant function analysis. We have now applied this methodology to various colonies of two species of ants of the genus Ectatomma in the Brazilian Cerrado. There were clear interspecific differences in cuticular hydrocarbons of these ants, with a small intraspecific variation. The differences between colonies were greater in E. brunneum than in E. vizottoi. Genetic differences among the colonies and species were well estimated by Fourier transform infrared photoacoustic spectroscopy and statistical analyses.

Influence of urbanization on stream fish assemblages in three microbasins in the Upper Paraná River Basin / Influência da urbanização em assembleias de peixes de riachos em três microbacias na bacia do Alto Rio Paraná

The colonization pattern of fish assemblages in streams is often studied in the context of environmental filters. On the other hand, when fish assemblages are subjected to anthropogenic effects, variables associated with environmental quality assume more importance. Therefore, this work evaluated the richness and composition of fish from streams sampled at different urbanization levels, aiming to determine any direct effects on the structure of fish assemblages. To accomplish this, samples were collected from 2003 to 2011 at 31 sites distributed among 3 microbasins in the Rio Ivinhema Basin, Alto Rio Paraná. Based on environmental variables, physicochemical of the water and analysis of the use and occupation of the soil, the microbasins were classified into different urbanization levels (low, medium and high). A total of 4,320 individuals were sampled, out of which 57 fish species were recorded. Sampled sites with medium urbanization level presented higher richness compared to sampled sites with high urbanization level which presented lower richness. Species richness in these sites was explained mainly by water temperature and water velocity. Results confirmed that urbanization does directly affect environmental integrity, which, in turn, can lead to the homogenization of stream assemblages.

Estudos sobre assembleias de peixes em riachos enfatizam o papel dos filtros ambientais associados ao padrão de colonização das assembleias, por outro lado, quando a assembleia está sujeita aos efeitos antropogênicos, as variáveis ambientais associadas à qualidade ambiental assumem maior importância. Dessa forma, o objetivo deste estudo foi analisar a riqueza e a composição de peixes de riachos amostrados em diferentes níveis de urbanização, buscando evidenciar se o efeito reflete diretamente na estrutura das assembleias. As amostragens foram realizadas em 31 locais distribuídos em três microbacias na bacia Rio Ivinhema, Alto Rio Paraná, no período de 2003 a 2011. Com base nas variáveis ambientais, físico-químicos da água e análise do uso e ocupação do solo as microbacias foram classificadas em diferentes níveis de urbanização (baixo, médio e alto). Foram amostrados um total 4.320 indivíduos, dos quais foram registradas 57 espécies de peixes. Os locais amostrados com influência média da urbanização apresentaram maior riqueza de espécies, entretanto, os locais amostrados com alta influência da urbanização apresentaram menor riqueza de espécies. Dessa forma, constatamos que a urbanização influencia diretamente na integridade ambiental, que pode levar a homogeneização das assembleias de riachos.

Influence of urbanization on stream fish assemblages in three microbasins in the Upper Paraná River Basin

Abstract The colonization pattern of fish assemblages in streams is often studied in the context of environmental filters. On the other hand, when fish assemblages are subjected to anthropogenic effects, variables associated with environmental quality assume more importance. Therefore, this work evaluated the richness and composition of fish from streams sampled at different urbanization levels, aiming to determine any direct effects on the structure of fish assemblages. To accomplish this, samples were collected from 2003 to 2011 at 31 sites distributed among 3 microbasins in the Rio Ivinhema Basin, Alto Rio Paraná. Based on environmental variables, physicochemical of the water and analysis of the use and occupation of the soil, the microbasins were classified into different urbanization levels (low, medium and high). A total of 4,320 individuals were sampled, out of which 57 fish species were recorded. Sampled sites with medium urbanization level presented higher richness compared to sampled sites with high urbanization level which presented lower richness. Species richness in these sites was explained mainly by water temperature and water velocity. Results confirmed that urbanization does directly affect environmental integrity, which, in turn, can lead to the homogenization of stream assemblages.

Resumo Estudos sobre assembleias de peixes em riachos enfatizam o papel dos filtros ambientais associados ao padrão de colonização das assembleias, por outro lado, quando a assembleia está sujeita aos efeitos antropogênicos, as variáveis ambientais associadas à qualidade ambiental assumem maior importância. Dessa forma, o objetivo deste estudo foi analisar a riqueza e a composição de peixes de riachos amostrados em diferentes níveis de urbanização, buscando evidenciar se o efeito reflete diretamente na estrutura das assembleias. As amostragens foram realizadas em 31 locais distribuídos em três microbacias na bacia Rio Ivinhema, Alto Rio Paraná, no período de 2003 a 2011. Com base nas variáveis ambientais, físico-químicos da água e análise do uso e ocupação do solo as microbacias foram classificadas em diferentes níveis de urbanização (baixo, médio e alto). Foram amostrados um total 4.320 indivíduos, dos quais foram registradas 57 espécies de peixes. Os locais amostrados com influência média da urbanização apresentaram maior riqueza de espécies, entretanto, os locais amostrados com alta influência da urbanização apresentaram menor riqueza de espécies. Dessa forma, constatamos que a urbanização influencia diretamente na integridade ambiental, que pode levar a homogeneização das assembleias de riachos.

Influence of urbanization on stream fish assemblages in three microbasins in the Upper Paraná River Basin / Influência da urbanização em assembleias de peixes de riachos em três microbacias na bacia do Alto Rio Paraná

Abstract The colonization pattern of fish assemblages in streams is often studied in the context of environmental filters. On the other hand, when fish assemblages are subjected to anthropogenic effects, variables associated with environmental quality assume more importance. Therefore, this work evaluated the richness and composition of fish from streams sampled at different urbanization levels, aiming to determine any direct effects on the structure of fish assemblages. To accomplish this, samples were collected from 2003 to 2011 at 31 sites distributed among 3 microbasins in the Rio Ivinhema Basin, Alto Rio Paraná. Based on environmental variables, physicochemical of the water and analysis of the use and occupation of the soil, the microbasins were classified into different urbanization levels (low, medium and high). A total of 4,320 individuals were sampled, out of which 57 fish species were recorded. Sampled sites with medium urbanization level presented higher richness compared to sampled sites with high urbanization level which presented lower richness. Species richness in these sites was explained mainly by water temperature and water velocity. Results confirmed that urbanization does directly affect environmental integrity, which, in turn, can lead to the homogenization of stream assemblages.

Resumo Estudos sobre assembleias de peixes em riachos enfatizam o papel dos filtros ambientais associados ao padrão de colonização das assembleias, por outro lado, quando a assembleia está sujeita aos efeitos antropogênicos, as variáveis ambientais associadas à qualidade ambiental assumem maior importância. Dessa forma, o objetivo deste estudo foi analisar a riqueza e a composição de peixes de riachos amostrados em diferentes níveis de urbanização, buscando evidenciar se o efeito reflete diretamente na estrutura das assembleias. As amostragens foram realizadas em 31 locais distribuídos em três microbacias na bacia Rio Ivinhema, Alto Rio Paraná, no período de 2003 a 2011. Com base nas variáveis ambientais, físico-químicos da água e análise do uso e ocupação do solo as microbacias foram classificadas em diferentes níveis de urbanização (baixo, médio e alto). Foram amostrados um total 4.320 indivíduos, dos quais foram registradas 57 espécies de peixes. Os locais amostrados com influência média da urbanização apresentaram maior riqueza de espécies, entretanto, os locais amostrados com alta influência da urbanização apresentaram menor riqueza de espécies. Dessa forma, constatamos que a urbanização influencia diretamente na integridade ambiental, que pode levar a homogeneização das assembleias de riachos.

Analysis of Ischemic Cholangiopathy After Treatment of Arterial Thrombosis in Liver Transplantation in Our Series.

Liver transplantation offers patients with terminal liver disease an effective treatment accompanied by excellent quality of life, but it also has complications, such as hepatic artery thrombosis and development of ischemic cholangiopathy, described in 3%-17% of patients. It is a very important cause of morbidity and mortality. The objective of this report was to analyze the efficacy of the treatment they received in relation to the development of ischemic cholangiopathy and a comparative survival analysis and to propose prophylactic measures for high-risk patients.

Liver Transplantation in Recipients With High Model for End-stage Liver Disease Score.

OBJECTIVES: The score in the Model of End-stage Liver Disease, or MELD, is a good indicator of the survival in patients on the liver transplant waiting list. In this study, an analysis is performed on the benefits of liver transplant on those patients with a very high MELD score and who thus start from a very severe baseline state that could affect the surgical outcome. MATERIALS AND METHODS: A prospective study was conducted on a cohort of 331 patients that received a liver transplant between 2002 and 2014. The patients were divided into 2 groups according to the MELD score (<28 vs ≥28), and differences in age, postoperative complications, stay in the intensive care unit (ICU), hospital stay, and survival were compared. RESULTS: Of the total of 331 patients, 21 (6.3%) had a MELD score ≥ 28. The mean age of the group with MELD score ≥ 28 was lower than the age in the group with MEDL score < 28 (42.5 vs 53.7 years; P < .0001). No significant increase was observed in postoperative complications. Although there were also no differences in survival, the group with MELD score ≥ 28 did have a longer stay in ICU and a longer hospital stay (with a mean of 6.7 days in ICU and 41.5 days admission vs 4.1 and 26.9, respectively). CONCLUSIONS: A very high MELD score is associated with a longer stay in ICU and more days of hospital admission, although no differences were observed in postoperative complications or survival. Therefore, there does not seem to be any contraindication in transplantation in this group of patients.