Prognostic index consisting of early post-transplant variables <2 weeks in adult living-donor liver transplantation.

ABSTRACT: AIM:Six-month recipient mortality after adult-to-adult living-donor liver transplantation (LDLT) remains high. Early and accurate prediction of recipient outcome and continuous monitoring of recipient severity after surgery are both essential for guiding appropriate care. This study was designed to identify early post-transplant parameters associated with 6-month mortality, and thereby to construct a discriminatory prognostic index (PI). METHODS:We retrospectively analyzed 400 consecutive primary adult-to-adult LDLTs in our center (2006-2017). Perioperative variables were comprehensively analyzed for their accuracy in predicting recipient mortality by comparing the area under the receiver operating characteristic (AUROC) of each factor. RESULTS:The AUROCs of preoperative predictive factors, for example, Model for End-stage Liver Disease (MELD) score and donor age, were 0.56 and 0.64, respectively, whereas those of post-transplant platelet count (PLT), total bilirubin (T-BIL), and prothrombin time - international normalized ratio (INR) on postoperative day (POD)-7-14 were 0.71/0.84, 0.68/0.82, and 0.71/0.78, respectively. Logistic regression analysis provided a formula: PIPOD-14 ?=?3.39?+?0.12?×?PLTPOD-14 ?-?0.09?×?T-BILPOD-14 ?-?1.23?×?INRPOD-14 , indicating a high AUROC of 0.87. Recipient 6-month survival with PIPOD-14 ?

SUBMITTER: Kusakabe J 

PROVIDER: S-EPMC7317571 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature