Risk factors associated with outcome in liver retransplantation: multicentric study.
OBJECTIVE
To externally validate the predictive mathematical model of survival designed by Linhares et al. (2006).


METHODS
This retrospective study was conducted on 217 individuals submitted to liver retransplantation from January 2000 to December 2008 in four European centers. The following variables were obtained on the recipient: age, creatinine, urgency of retransplantation and time between transplantation and retransplantation. The Kaplan-Meier survival curve and ROC curve were used to validate the mathematical model.


RESULTS
The present results showed a similar pattern of survival compared to the study of Linhares et al. (2006) concerning the biological variations, when survival curves were compared for each of the four variables analyzed between both samples. When compared, the areas below the ROC curve (aROC) of derivation (0.733) and validation samples (0.593) presented significant difference (p = 0.005), revealing low relationship of sensitivity and specificity between the two curves. Similarity was observed in Kaplan-Meier survival curves.


CONCLUSIONS
This study allowed external validation by the Kaplan-Meier survival curves of the predictive mathematical model of survival in liver retransplantation proposed by Linhares et al. (2006). However, validation through the ROC curve, the aROC, evidenced weak discrimination ability.
Rogério O
RO
Mattos
Marcelo M
MM
Linhares
Délcio
D
Matos
René
R
Adam
Henri
H
Bismuth
Denis
D
Castaing
Achim
A
Konietzko
Jan
J
Lerut
Robert J
RJ
Porte
Jamieson
J
Neville
Daniel
D
Azoulay
D000328:Adult; D000367:Age Factors; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D003661:Decision Support Techniques; D017558:Elective Surgical Procedures; D004630:Emergencies; D005060:Europe; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D008297:Male; D018579:Patient Selection; D011237:Predictive Value of Tests; D012372:ROC Curve; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D003404:Creatinine