title: Survival Outcomes Following Pediatric Liver Transplantation (Pedi-SOFT) Score: A Novel Predictive Index.
abstract: A prognostic index to predict survival after liver transplantation could address several clinical needs. Here, we devised a scoring system that predicts recipient survival after pediatric liver transplantation. We used univariate and multivariate analysis on 4565 pediatric liver transplant recipients data and identified independent recipient and donor risk factors for posttransplant mortality at 3 months. Multiple imputation was used to account for missing variables. We identified five factors as significant predictors of recipient mortality after pediatric liver transplantation: two previous transplants (OR 5.88, CI 2.88-12.01), one previous transplant (OR 2.54, CI 1.75-3.68), life support (OR 3.68, CI 2.39-5.67), renal insufficiency (OR 2.66, CI 1.84-3.84), recipient weight under 6 kilograms (OR 1.67, CI 1.12-2.36) and cadaveric technical variant allograft (OR 1.38, CI 1.03-1.83). The Survival Outcomes Following Pediatric Liver Transplant score assigns weighted risk points to each of these factors in a scoring system to predict 3-month recipient survival after liver transplantation with a C-statistic of 0.74. Although quite accurate when compared with other posttransplant survival models, we would not advocate individual clinical application of the index.
authors.affiliation: Division of Abdominal Transplantation ﻿ and Division of Hepatobiliary Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.|Department of Surgery, Texas Children's Hospital, Houston, TX.
authors.forename: A
authors.initials: A
authors.lastname: Rana
authors.affiliation: Division of Abdominal Transplantation ﻿ and Division of Hepatobiliary Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Z S
authors.initials: ZS
authors.lastname: Pallister
authors.affiliation: Division of Abdominal Transplantation ﻿ and Division of Hepatobiliary Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: J J
authors.initials: JJ
authors.lastname: Guiteau
authors.affiliation: Division of Abdominal Transplantation ﻿ and Division of Hepatobiliary Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: R T
authors.initials: RT
authors.lastname: Cotton
authors.affiliation: Division of Transplantation, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: K
authors.initials: K
authors.lastname: Halazun
authors.affiliation: Division of Abdominal Transplantation ﻿ and Division of Hepatobiliary Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: C C
authors.initials: CC
authors.lastname: Nalty
authors.affiliation: Division of Abdominal Transplantation ﻿ and Division of Hepatobiliary Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: S A
authors.initials: SA
authors.lastname: Khaderi
authors.affiliation: Division of Abdominal Transplantation ﻿ and Division of Hepatobiliary Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.|Department of Surgery, Texas Children's Hospital, Houston, TX.
authors.forename: C A
authors.initials: CA
authors.lastname: O'Mahony
authors.affiliation: Division of Abdominal Transplantation ﻿ and Division of Hepatobiliary Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.|Department of Surgery, Texas Children's Hospital, Houston, TX.
authors.forename: J A
authors.initials: JA
authors.lastname: Goss
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D023381:Endpoint Determination / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008962:Models, Theoretical; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Clinical decision-making; United Network for Organ Sharing (UNOS); patient survival