Scoring short-term mortality after liver transplantation.
Liver transplantation can prolong survival and improve the quality of life of patients with end-stage liver disease. This study retrospectively reviewed the medical records of 149 patients who had received liver transplants in a tertiary care university hospital from January 2000 to December 2007. Demographic, clinical, and laboratory variables were recorded. Each patient was assessed by 4 scoring systems before transplantation and on postoperative days 1, 3, 7, and 14. The overall 1-year survival rate was 77.9%. The Sequential Organ Failure Assessment (SOFA) score had better discriminatory power than the Child-Pugh points, Model for End-Stage Liver Disease score, and RIFLE (risk of renal dysfunction, injury to the kidney, failure of the kidney, loss of kidney function, and end-stage kidney disease) criteria. Moreover, the SOFA score on day 7 post-liver transplant had the best Youden index and highest overall correctness of prediction for 3-month (0.86, 93%) and 1-year mortality (0.62, 81%). Cumulative survival rates at the 1-year follow-up after liver transplantation differed significantly (P < 0.001) between patients who had SOFA scores < or = 7 on post-liver transplant day 7 and those who had SOFA scores > 7 on post-liver transplant day 7. In conclusion, of the 4 evaluated scoring systems, only the SOFA scores calculated before liver transplantation were statistically significant predictors of 3-month and 1-year posttransplant mortality. SOFA on post-liver transplant day 7 had the best discriminative power for predicting 3-month and 1-year mortality after liver transplantation.
Wong
Chung-Shun
CS
Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan.
Lee
Wei-Chen
WC
Jenq
Chang-Chyi
CC
Tian
Ya-Chung
YC
Chang
Ming-Yang
MY
Lin
Chan-Yu
CY
Fang
Ji-Tseng
JT
Yang
Chih-Wei
CW
Tsai
Ming-Hung
MH
Shih
Hsin-Chin
HC
Chen
Yung-Chang
YC
D000328:Adult; D005260:Female; D006801:Humans; D017093:Liver Failure / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index