Currently allocation of liver organs through the MELD system and the impact on patient outcome is a hot debate. Data on the impact of preoperatively assessed MELD score on the morbidity and mortality of postoperative recipients are only few. This study correlated morbidity, but not mortality with the MELD score in patients after liver transplantation in uni-and multivariate analyses and demonstrated a MELD score above 23 to be an independent risk factor for an ICU stay longer than 10 days (odds ratio 7.0). Siniscalchi and colleagues reported a correlation of MELD score and postoperative complications in 242 liver transplants [20] . Interestingly, the MELD scores in that study were similar to our findings (22.8 vs. 22 .3 in our study in the high morbidity group and 17.6 vs. 18.8 in the low morbidity group). Another study associated increased length of stay in the ICU in association with high MELD score above 30 [7] , but failed to find a difference in mortality. Only in patients exceeding a MELD score of 36, mortality seems to be predicted by MELD as reported from Saab and colleagues [21] . In our population, four patients showed MELD score above 35, three of them died in the postoperative course. In contrast, a study of 340 transplanted patients showed no difference in early death in respect to the MELD score [8] . Several other publications from the USA have also document that MELD score cannot predict survival after liver transplantation [22] [23] [24] . Nevertheless, the question of whether very high MELD scores affect mortality remains elusive. Taken together, despite no clear correlation of MELD score and postoperative mortality, there is strong [25] . Another finding of this study was a high incidence of postoperative renal failure and subsequently need for RRT. Cox proportional hazard model revealed RRT in the ICU as an independent risk factor for mortality. RRT in our population was necessary in 21.8% during ICU stay. Other studies reported an incidence ranging from 3% to 20% [26] [27] [28] depending on the severity of preexisting renal conditions. Our study population included seven cases of pretransplant RRT already in need of RRT. This fact probably contributed to a higher incidence of renal failure when compared with those studies.