Prediction of survival after liver transplantation for chronic severe hepatitis B based on preoperative prognostic scores: a single center's experience in China.
BACKGROUND
The aim of this study was to estimate the utility of a preoperative model of end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) score in predicting the prognosis after othotopic liver transplantation (OLT) for chronic severe hepatitis B (CSHB) and explore the prognostic factors.


METHODS
The outcome of 137 patients who underwent OLT using donors after cardiac death (DCDs) for CSHB in our center was reviewed retrospectively. Survival analysis was performed using the Kaplan-Meier method; the log-rank test was used for univariate analysis; and the Cox proportional hazards regression model was used for prognostic factors screening.


RESULTS
The overall mortality rate was 33.6% (46/137); and 1-month, 6-month, 1-year, and 5-year patient survival rates were 75.8, 72.0, 71.0, and 60.1%, respectively. Most patients (33/46) died during the first month after OLT. The area under the curve values generated by the receiver operating characteristics curves were 0.82 [95% confidence interval (CI) 0.72-0.92] and 0.68 (95% CI 0.58-0.79), respectively (P < 0.01), for the MELD and CTP models in predicting 1-month mortality after OLT. Patients with a preoperative MELD score <33.8 or a CTP score <12.5 had significantly better prognosis than those with higher scores (P < 0.05). Other mortality predictors include hepatic encephalopathy, preoperative infection, serum creatinine > or = 1.5 mg/dl.


CONCLUSIONS
The MELD score was more efficient than the CTP score for evaluating the short-term prognosis in patients with CSHB undergoing OLT using DCDs, which should be taken into consideration during graft allocation.
Xiao
Liang
L
Department of Liver Transplantation, Shanghai Changzheng Hospital, 415 Fengyang Road, Shanghai 200003, People's Republic of China.
Fu
Zhi-Ren
ZR
Ding
Guo-Shan
GS
Fu
Hong
H
Ni
Zhi-Jia
ZJ
Wang
Zheng-Xin
ZX
Shi
Xiao-Min
XM
Guo
Wen-Yuan
WY
Ma
Jun
J
D000328:Adult; D000368:Aged; D002681:China; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000601:surgery*; D006801:Humans; D017093:Liver Failure / Q000209:etiology; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
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