Comparison of Different Scoring Systems in Predicting Short-Term Mortality After Liver Transplantation

El-Sayed, Farid G.; Sholkamy, Amany; Elshazli, Mostafa; El-Shafie, M.; Naguib, Marianne J.

doi:10.1016/j.transproceed.2014.11.067

Cited by 20 publications

(5 citation statements)

References 23 publications

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“…The reasons may be related to (1) the inclusion of patients in our study with relatively low SCr level (we excluded patients who are on RRT as they are not “at risk” for post-operative renal injury); (2) the MELD score lacking systematic observed indicators, such as ascites, blood loss, hepatic encephalopathy, etc., but not just SCr, INR, total bilirubin; hence, estimating the prognosis of patients who have no preoperative AKI was not suitable 51 ; and (3) the Sequential Organ Failure Assessment score having the best discriminatory power for prediction of short-term mortality after OLT as indicated by Elsayed et al . 52 . In addition, hypoalbuminemia in Cabezuelo et al .’s study 3 showed a significant difference between two groups, but it was contradictory to our results.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of acute kidney injury after orthotopic liver transplantation in China

Yin

Funian

et al. 2017

Sci Rep

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In this study, we determined the risk factors for acute kidney injury (AKI) following orthotopic liver transplantation (OLT) in China. We collected 5074 donation after cardiac death (DCD) OLT recipients who underwent surgery between January 1, 2010, and December 31, 2015, in 86 academic hospitals or transplant centers in China. Univariate and multivariate analyses were used to investigate the criticality of donor, graft, or recipient variables in the development of post-OLT AKI. In all, 4482 patients were included (median age, 49.31 years). Post-OLT AKI occurred in 3.97% patients, and 73.6% of all OLT patients were male. The 1- and 5-year cumulative survival rates (CSRs) of the AKI group were 33.95% and 25.24%, respectively, compared with 86.34% and 70.05%, respectively, of the non-AKI group (P < 0.001). The independent risk factors for post-OLT AKI were blood loss, cold ischemia time, warm ischemia time, preoperative serum creatinine, the treatment period with dopamine, overexposure to calcineurin inhibitor, and combined mycophenolate mofetil use (P < 0.05). These had a high prediction accuracy for post-OLT AKI (area under the curve [AUC] = 0.740).

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Section: Discussionmentioning

confidence: 99%

Risk factors of acute kidney injury after orthotopic liver transplantation in China

Yin

Funian

et al. 2017

Sci Rep

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“…Elsayed et al demonstrated that the duration of ICU stay is also a significant risk factor related to early mortality after living donor liver transplantation [ 23 ]. However, in the current study, the ICU stay length between the 2 groups did not differ significantly.…”

Section: Discussionmentioning

confidence: 99%

Sequential Organ Failure Assessment (SOFA) Score-Based Factors Predict Early Mortality in High-Risk Patients with Living Donor Liver Transplant

et al. 2021

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Background Patients with a Sequential Organ Failure Assessment (SOFA) score >7 on post-transplant day (POD) 7 have been reported to have a higher risk of short-term mortality after living donor liver transplant (LDLT). We sought to identify factors that were associated with early mortality in this high-risk population. Material/Methods A total of 102 patients with a high SOFA score (>7) on POD 7 were enrolled, of which 72 (70.6%) were assigned to the survivor group, and the other 30 (29.4%) patients were assigned to the non-survivor group according to post-transplant 3-month results. Demographics, clinical data, operative parameters, and individual SOFA component scores were collected. Independent risk factors for 3-month mortality were identified by multivariate logistic regression analysis using backward elimination procedures. Results Of 102 high SOFA score patients, the 3-month mortality rate after LDLT in our study was 29.4%. Four independent risk factors were indicative for early death: graft-to-recipient weight ratio (GRWR) <0.8 (hazard ratio [HR]=3.00; 95% CI=1.05–8.09; P =0.041), longer warm ischemia time (HR=37.84; 95% CI=1.63–880.77; P =0.024), high liver component of the SOFA score, and cardiovascular component of the SOFA score (liver component: HR=10.39; 95% CI=1.77–60.89; P =0.009 and cardiovascular component: HR=13.34; 95% CI=2.22–80.12; P =0.005). Conclusions In conclusion, 3-month mortality among patients with high SOFA score on POD 7 is associated with multiple independent risk factors, including smaller GRWR, longer warm ischemia time, and higher category of liver and cardiovascular component of SOFA score. By recognizing high-risk patients earlier, the LDLT outcomes may be improved by timely intensive therapies.

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“…21 Pan et al showed the Chronic Liver Failure - the Sequential Organ Failure Assessment (CLIF-SOFA score) on post-transplantation day (POD) 7 had the best discriminative power for predicting 1-year mortality after LT. 22 Elsayed et al showed that SOFA score on POD 7 had the best discriminative power for predicting 3-month mortality. 23 Pareja et al showed model of early allograft function on POD 3 was a suitable candidate for predicting PNF, 3-month graft loss, and patient mortality. 24 Carrroll et al showed that the PRISM score on POD 1 was a prognostic indicator for the length of ICU stay and 1-year survival.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Risk Factors and Outcome of Patients With Liver Transplantation Who Were Admitted to Pediatric Intensive Care Unit: A 10-Year Single-Center Review in China

Qian

Qiu

Xiang

et al. 2019

J Intensive Care Med

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Introduction: The aim of this study was to present our 10-year experience of pediatric intensive care unit (PICU) management with pediatric liver recipients and to understand the importance of close interdisciplinary cooperation in 2 hospitals. Methods: A retrospective chart review study was performed according to our hospital’s medical records and the pediatric liver transplant database of Renji hospital. Results: A total of 767 patients received liver transplantation (LT) performed in Renji hospital between October 2006 and December 2016, of which 97 of them were admitted to PICU in our center for various complications developed after transplantation. 8.8% (16/208) and 14.4% (81/559) of patients were transferred to PICU in stages I and II, respectively, and was comparable in the 2 stages ( P = .017). The majority of patients was late postoperative children (median 185 post-LT days) in stage I. More patients were transferred to PICU directly in stage II. PICU admitted more younger (median 8.2 months) and early postoperative patients in stage II. The median length of PICU stay was 11.0 (6.0-20.5) days. The median length of mechanical ventilation was 5.0 (0.0-12.0) days. The most frequent complications were pulmonary complications (52 [53.6%] patients), surgical complications (22 [22.7%] patients), sepsis (7 [7.2%]), and other miscellaneous complications (16 [16.5%] patients). The overall 28-day PICU mortality was 25.8% (n = 25) and 64.0% (n = 16) of the deaths happened in the early postoperative period. There was significant difference concerning mortality in children with surgical complications and medical problems (54.5% [12/22] vs 17.3% [13/75], P = .001). Multivariate analysis by regression showed that the pediatric risk of mortality III score was the only independent prognostic factor ( P = .031). Conclusions: Multiple complications occur in children with LT. Although challenging, interdisciplinary cooperation between different hospitals is an effective mean to enable children to maximize the benefit gained from LT in China.

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Comparison of Different Scoring Systems in Predicting Short-Term Mortality After Liver Transplantation

Cited by 20 publications

References 23 publications

Risk factors of acute kidney injury after orthotopic liver transplantation in China

Risk factors of acute kidney injury after orthotopic liver transplantation in China

Sequential Organ Failure Assessment (SOFA) Score-Based Factors Predict Early Mortality in High-Risk Patients with Living Donor Liver Transplant

Postoperative Risk Factors and Outcome of Patients With Liver Transplantation Who Were Admitted to Pediatric Intensive Care Unit: A 10-Year Single-Center Review in China

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