Different Score Systems to Predict Mortality in Living Donor Liver Transplantation: Which Is the Winner? The Experience of an Egyptian Center for Living Donor Liver Transplantation

Amir, Mona El; Eldeen, Hadeel Gamal; Mogawer, Sherif; Esmat, Gamal; El-Shazly, Mostafa; El-Garem, Nouman; Abdelaziz, Magda; Salah, Ayman; Hosny, Adel

doi:10.1016/j.transproceed.2015.10.022

Cited by 6 publications

(12 citation statements)

References 15 publications

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“…In this regard, recent advances in diagnostic imaging enable direct measurement of the TTV, and have indicated an association between TTV and prognosis for patients with many types of solid tumour, including hepatocellular carcinoma, which is the most prevalent liver cancer. In patients with hepatocellular carcinoma who underwent liver transplantation or hepatic resection, TTV has been reported as a good predictor of recurrence‐free (RFS) and overall (OS) survival. However, the association between TTV and prognosis in patients with CRLM has not been studied.…”

Section: Introductionmentioning

confidence: 99%

Total tumour volume as a prognostic factor in patients with resectable colorectal cancer liver metastases

Tai¹,

Komatsu²,

Sofue

et al. 2020

BJS Open

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Background: Although total tumour volume (TTV) may have prognostic value for hepatic resection in certain solid cancers, its importance in colorectal liver metastases (CRLM) remains unexplored. This study investigated its prognostic value in patients with resectable CRLM.Method: This was a retrospective review of patients who underwent hepatic resection for CRLM between 2008 and 2017 in a single institution. TTV was measured from CT images using three-dimensional construction software; cut-off values were determined using receiver operating characteristic (ROC) curve analyses. Potential prognostic factors, overall survival (OS) and recurrence-free survival (RFS) were determined using multivariable and Kaplan-Meier analyses.Results: Some 94 patients were included. TTV cut-off values for OS and RFS were 100 and 10 ml respectively. Right colonic primary tumours, primary lymph node metastasis and bilobar liver metastasis were included in the multivariable analysis of OS; a TTV of 100 ml or above was independently associated with poorer OS (hazard ratio (HR) 6⋅34, 95 per cent c.i. 2⋅08 to 17⋅90; P = 0⋅002). Right colonic primary tumours and primary lymph node metastasis were included in the RFS analysis; a TTV of 10 ml or more independently predicted poorer RFS (HR 1⋅90, 1⋅12 to 3⋅57; P = 0⋅017). The 5-year OS rate for a TTV of 100 ml or more was 41 per cent, compared with 67 per cent for a TTV below 100 ml (P = 0⋅006). Corresponding RFS rates with TTV of 10 ml or more, or less than 10 ml, were 14 and 58 per cent respectively (P = 0⋅009). A TTV of at least 100 ml conferred a higher rate of unresectable initial recurrences (12 of 15, 80 per cent) after initial hepatic resection.Conclusion: TTV was associated with RFS and OS after initial hepatic resection for CRLM; TTV of 100 ml or above was associated with a higher rate of unresectable recurrence.

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Section: Introductionmentioning

confidence: 99%

Total tumour volume as a prognostic factor in patients with resectable colorectal cancer liver metastases

Tai¹,

Komatsu²,

Sofue

et al. 2020

BJS Open

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“…Preoperative assessment of the liver function is quite important because it is connected to the severity of liver disease, thereby predicting time on the waiting list and postoperative short- or long-term outcomes [ 8 , 9 ]. Various prognostic scores have been devised to predict the outcome of LT; the most commonly used systems are the Model for End-Stage Liver Disease (MELD) and Child-Pugh stage [ 10 ]. More recently, Johnson et al developed a novel but simple model, named the Albumin-Bilirubin (ALBI) grade, to assess liver function in patients with HCC [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Albumin-Bilirubin Score for Predicting Post-Transplant Complications Following Adult-to-Adult Living Donor Liver Transplantation

et al. 2018

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BackgroundAlbumin-Bilirubin (ALBI) grade has been evaluated as an objective method to assess liver function and predict postoperative complications, particularly after hepatectomy in patients with hepatocellular carcinoma (HCC). However, ALBI grade was rarely used in evaluation in living donor liver transplantation (LDLT).Material/MethodsBetween March 2005 and November 2015, 272 consecutive patients undergoing right-lobe LDLT were enrolled in this study. According to the ALBI score used to evaluate recipients preoperatively, those patients were divided into 3 grades (I, II, and III). Demographic findings and the post-operative complication rates were collected and compared among groups.ResultsThe proportions of massive blood cell transfusions were different among those 3 grades (p<0.05). The patients in grade III had a higher risk of bacterial pneumonia and early allograft dysfunction (EAD) compared to grade I (p=0.029 and p=0.038, respectively) and grade II (p=0.006 and p=0.007, respectively). The area under the receiver operating characteristic curve of ALBI, Child-Pugh, and MELD for predicting 30-day mortality were 0.702 (95% CI: 0.644–0.756), 0.669 (95% CI: 0.580–0.697, p=0.510, versus ALBI grade), and 0.540 (95% CI: 0.580–0.697, p=0.144, versus ALBI grade), respectively.ConclusionsALBI grade was a good index for predicting post-operative complications and had a predictive ability similar to those of the Child-Pugh classification and MELD score.

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“…Different scoring systems have been proposed to predict the outcome of deceased-donor liver transplantation, but heir impact on the outcome in living LDLT has not yet been elucidated. 8 Our results show that the MELD score has a great impact on mortality post-LDLT, being significantly higher in the early mortality patients. The same result was reported by Rogério et al, who found that higher MELD scores were associated with higher early mortality after LDLT.…”

Section: Discussionmentioning

confidence: 52%

Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt

Nafea

Alsebaey²,

Sultan

et al. 2019

Ann Saudi Med

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BACKGROUND: Living donor liver transplantation (LDLT) has evolved into a widely accepted therapeutic option. Many different risk factors may affect early mortality after LDLT.OBJECTIVES: Analyze risk factors that can affect early (<6 months) mortality of patients after LDLT in a single center.DESIGN: Retrospective chart review of patients who underwent LDLT.SETTING: University hospital.PATIENTS AND METHODS: Adult cirrhotic patients who underwent LDLT were classified by early (first 6 months) or late mortality. A full pre, intra- and post-operative evaluation had been done on all patients including a full history, examination and investigations to identify risk factors that might affect mortality post-LDLT.MAIN OUTCOME MEASURES: Determination of pre-, intra- or postoperative factors that might affect recipient mortality post-LDLT.SAMPLE SIZE: 123.RESULTS: Pre-operative factors that increased early mortality in a univariate analysis were higher model for end-stage liver disease (MELD) scores, lower graft-recipient weigh ratio (GRWR), older donor age, and recurrent spontaneous bacterial peritonitis. Intraoperative factors included more transfusion units of blood, plasma, platelets and cryoprecipitate, a longer time for cold and warm ischemia, and a longer anhepatic phase among others. Postoperative factors included a longer ICU or hospital stay and abnormal postoperative laboratory data. In the final logistic regression model, the most significant factors were pre-operative GRWR, length of hospital stay, units of intraoperative blood transfusion, postoperative alanine aminotransferase, postoperative total leukocyte count, and MELD score.CONCLUSION: LDLT outcomes might be improved by attempting to resolve clinical factors that have been identified as contributors to early post-LDLT mortality.LIMITATIONS: More risk factors, such as those relevant to patient portal vein hemodynamics, should be included in an analysis of predictors of early mortality.CONFLICT OF INTEREST: None.

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Different Score Systems to Predict Mortality in Living Donor Liver Transplantation: Which Is the Winner? The Experience of an Egyptian Center for Living Donor Liver Transplantation

Cited by 6 publications

References 15 publications

Total tumour volume as a prognostic factor in patients with resectable colorectal cancer liver metastases

Total tumour volume as a prognostic factor in patients with resectable colorectal cancer liver metastases

Albumin-Bilirubin Score for Predicting Post-Transplant Complications Following Adult-to-Adult Living Donor Liver Transplantation

Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt

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