This study examined the relationship between the MELD-XI score and mortality in patients who received an orthotopic heart transplant (OHT). The researchers analyzed data from over 27,000 OHT patients between 2002-2012 from the United Network for Organ Sharing database. They found that 22% of patients had a MELD-XI score over 17 at the time of transplant. Higher MELD-XI scores were associated with significantly lower 30-day, 1-year, and 5-year survival rates compared to those with lower scores. After adjusting for other factors, a high MELD-XI score remained an independent predictor of increased mortality at 30 days, 1 year, and 5 years following OHT. This large study demonstrates