Prognostic index consisting of early post-transplant variables <2 weeks in adult living-donor liver transplantation.
ROC curve
bilirubin
liver transplantation
mortality
prothrombin time
thrombocytopenia
Journal
Hepatology research : the official journal of the Japan Society of Hepatology
ISSN: 1386-6346
Titre abrégé: Hepatol Res
Pays: Netherlands
ID NLM: 9711801
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
15
12
2019
revised:
21
01
2020
accepted:
26
01
2020
pubmed:
6
2
2020
medline:
6
2
2020
entrez:
4
2
2020
Statut:
ppublish
Résumé
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). 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. 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: PI A novel, post-transplant survival estimator, PI, accurately predicts recipient 6-month mortality within 1-2 weeks after adult LDLT. Daily monitoring of PI could facilitate early interventions including retransplantation in critically ill patients.
Identifiants
pubmed: 32012392
doi: 10.1111/hepr.13489
pmc: PMC7317571
doi:
Types de publication
Journal Article
Langues
eng
Pagination
741-753Informations de copyright
© 2020 The Authors. Hepatology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Hepatology.
Références
Liver Transpl. 2016 Dec;22(12):1666-1675
pubmed: 27540888
Ann Surg. 2002 Dec;236(6):713-21; discussion 721
pubmed: 12454509
Transplantation. 2018 Mar;102(3):440-447
pubmed: 28968350
Liver Transpl. 2014 Feb;20(2):147-55
pubmed: 24123804
Transplantation. 2014 Feb 27;97(4):457-62
pubmed: 24531822
Liver Transpl. 2015 Jan;21(1):38-46
pubmed: 25204890
Ann Surg. 2017 Jan;265(1):166-172
pubmed: 28009742
JAMA Surg. 2018 May 1;153(5):436-444
pubmed: 29261831
Hepatol Res. 2019 Jun;49(6):687-694
pubmed: 30698359
Hepatol Res. 2019 Sep;49(9):964-980
pubmed: 31081572
Liver Transpl. 2003 Sep;9(9):S29-35
pubmed: 12942476
Transplant Proc. 2005 May;37(4):1718-9
pubmed: 15919443
Surgery. 2016 Jun;159(6):1623-1630
pubmed: 26936527
Am J Transplant. 2015 Jan;15(1):17-38
pubmed: 25358749
Liver Transpl. 2014 Apr;20(4):425-36
pubmed: 24478109
Am J Transplant. 2014 Jan;14(1):102-14
pubmed: 24279828
Ann Surg. 2007 Feb;245(2):315-25
pubmed: 17245187
Liver Transpl. 2010 Aug;16(8):943-9
pubmed: 20677285
Liver Transpl. 2012 May;18(5):602-7
pubmed: 22253117
Am J Transplant. 2005 Nov;5(11):2605-10
pubmed: 16212618
Liver Transpl. 2005 Nov;(11 Suppl 2):S14-20
pubmed: 16237729
Am J Transplant. 2008 Dec;8(12):2569-79
pubmed: 18976306
Stat Med. 1996 Feb 28;15(4):361-87
pubmed: 8668867
Liver Transpl. 2007 Feb;13(2):227-33
pubmed: 17256780
Transplantation. 2016 Jul;100(7):1490-9
pubmed: 27326811
Ann Surg. 2010 Feb;251(2):300-6
pubmed: 19779326
Hepatol Res. 2020 Jun;50(6):741-753
pubmed: 32012392
Ann Surg. 2015 Sep;262(3):465-75; discussion 473-5
pubmed: 26258315
Am J Epidemiol. 1982 Jan;115(1):92-106
pubmed: 7055134
Transplant Proc. 2014 Jan-Feb;46(1):81-6
pubmed: 24507030
Surg Today. 2011 Mar;41(3):317-22
pubmed: 21365409
Biom J. 2005 Aug;47(4):458-72
pubmed: 16161804
Liver Transpl. 2010 Jun;16(6):718-28
pubmed: 20517905
Transplantation. 2017 Aug;101(8):e258-e264
pubmed: 28557956
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
Transpl Int. 2014 Feb;27(2):141-51
pubmed: 24112236
Ann Surg. 2011 Sep;254(3):444-8; discussion 448-9
pubmed: 21817890
Ann Surg. 2018 Jun;267(6):1126-1133
pubmed: 28288061
Liver Transpl. 2007 Apr;13(4):579-88
pubmed: 17394164
Surg Clin North Am. 2004 Apr;84(2):481-93
pubmed: 15062657