title: Posttransplant mortality risk assessment for adult-to-adult right-lobe living donor liver recipients with benign end-stage liver disease.
abstract: OBJECTIVE
  A model for living donor liver transplantation (LDLT) outcomes, in concert with pretransplant disease severity assessment, would facilitate informed decision-making on both sides considering donation and transplantation. So far, however, few of studies have focused on models specifically for adult-to-adult right-lobe LDLT recipients with benign end-stage liver diseases. Therefore, we aimed to develop such a prognostic model based on easily obtainable and objective pretransplant characteristics.
  
  
  METHODS
  With data retrospectively collected on 120 recipients, we used Cox proportional-hazards regression to analyze six donor characteristics and 33 pretransplant recipient variables for correlation with posttransplant mortality. In both a modeling set and a prospective validation set with 30 recipients, the performances of the new Cox model, MELD, and MELD-Na+ were assessed by measuring both calibration ability and discriminative power with the Hosmer-Lemeshow test and receiver operating characteristic analysis, respectively.
  
  
  RESULTS
  By univariate and multivariate analysis, donor age, serum total bilirubin, creatinine, and HBV-DNA level were significantly associated with posttransplant mortality. The Cox model, employing these four variables, yielded good calibration ability in the modeling set χ² = 2.465, p = 0.653) and the validation set χ² = 2.836, p = 0.586), and high discriminative power in the modeling set (c-statistic = 0.826, p = 0.001) and validation set (c-statistic = 0.816, p = 0.028). The calibration ability and discriminative power of MELD and MELD-Na+ in both sets were poor.
  
  
  CONCLUSIONS
  The newly derived Cox model was valuable in posttransplant mortality risk assessment for adult-to-adult right-lobe LDLT recipients with benign end-stage liver diseases.
authors.affiliation: Liver Transplantation Center, West China Hospital, Sichuan University Medical School, Chengdu, P.R. China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.forename: Fei
authors.initials: F
authors.lastname: Yin
authors.forename: Bo
authors.initials: B
authors.lastname: Chen
authors.forename: Youping
authors.initials: Y
authors.lastname: Li
authors.forename: Lunan
authors.initials: L
authors.lastname: Yan
authors.forename: Tianfu
authors.initials: T
authors.lastname: Wen
authors.forename: Bo
authors.initials: B
authors.lastname: Li
mesh_terms: D000328:Adult; D000367:Age Factors; D001663:Bilirubin / Q000097:blood; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D058625:End Stage Liver Disease / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006515:Hepatitis B virus; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D009927:Tissue and Organ Procurement; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D003404:Creatinine; D001663:Bilirubin