Prediction of 6-month survival after liver transplantation using Cox regression.
BACKGROUND
The outcome of liver transplantation (LTx) has been correlated with several donor and recipient factors.


METHODS
A database of 191 consecutive LTx cases was analyzed using Kaplan-Meier and Cox regression statistics based on 80 variables. To avoid additional effects of late events on patient survival, the chosen endpoint was 6 months. Data were evaluated using SPSS statistical software.


RESULTS
Kaplan-Meier analysis revealed a difference in 1- to 6-month graft survival between patients transplanted with organs from donors older versus younger than 60 years (Breslow, P <.01). Differences in 1- to 6-month graft survivals were observed between patients listed as UNOS status 3, 2B, 2A, and 1: the outcomes for UNOS status 2B versus UNOS status 2A and UNOS status 2B versus status 1 were significant (P <.05). Differences in 1- to 6-month graft survival rates were found between patients with versus without sepsis (P <.05), and with versus without rejection episodes (P <.01). Cox regression analysis revealed only three of the variables to be independent prognostic predictors of graft failure: donor age; postoperative septic status; and rejection. The best mathematical multivariate Cox regression model linked donor age + donor Na + rejection + sepsis to 1- to 6-month graft survival (chi-square = 29.06, P <.001).


CONCLUSIONS
Factors predictive of 1- to 6-month graft survival after liver transplantation include donor age; UNOS status; sepsis; and rejection.
Avolio
A W
AW
Division of Organ Transplantation, Catholic University, Rome, Italy. alfonso.avolio@tin.it
Chirico
A S A
AS
Agnes
S
S
Sganga
G
G
Gaspari
R
R
Frongillo
F
F
Pepe
G
G
Castagneto
M
M
D000367:Age Factors; D016009:Chi-Square Distribution; D016208:Databases, Factual; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors / Q000145:classification*; D017211:Treatment Failure; D016896:Treatment Outcome