Development and Internal Validation of the MELD–ERT Score for Mortality Risk Stratification After Liver Transplantation

Background/Objectives: The Model for End-Stage Liver Disease (MELD) score reflects pretransplant disease severity, but does not capture intraoperative factors that may influence post-transplant outcomes. This study aimed to develop and internally validate a composite MELD–erythrocyte transfusion (ERT) score for mortality risk stratification after liver transplantation (LT).

Methods

This retrospective, single-center cohort study included 125 adult LT recipients between August 2024 and July 2026. A MELD–ERT score (0–2) was constructed using ROC-derived cut-offs for MELD and intraoperative ERT. Prognostic performance for mortality and overall survival (OS) was evaluated using regression, conventional and time-dependent ROC and survival analyses, with bootstrap internal validation.