The Glasgow Prognostic Score and its variants predict mortality in living donor but not in deceased donor liver transplantation for hepatocellular carcinoma: A double-center validation study.
OBJECTIVE
This study aimed to evaluate whether the Glasgow Prognostic Score (GPS) and its variants are able to predict mortality in live donor and deceased donor liver transplantation for hepatocellular carcinoma.


METHODS
Data of 29 live donor and 319 deceased donor transplantations from two German transplant centers was analyzed. The GPS, modified GPS, hepatic GPS, and Abe score were investigated. Receiver operating characteristic (ROC) curve analysis was carried out to calculate the sensitivity, specificity, and overall model correctness of the investigated scores as a predictive model. Study end-points were 1-year, 3-year, and long-term mortality.


RESULTS
A 1-year mortality of 19.1% (n = 61), 3-year mortality of 26.3% (n = 84), and overall mortality of 37.3% (n = 119) was observed. All investigated scores failed to predict outcome in deceased donor liver transplantation (areas under ROC curves <0.700), whereas GPS, hepatic GPS, modified GPS, and the Abe score reached areas under ROC curves >0.700 for the prediction of 1-year mortality in live donor transplantation. The GPS and Abe score were also able to predict 3-year mortality. None of the investigated scores was a reliable predictor of long-term mortality.


CONCLUSIONS
Systemic inflammation-based scores have great prognostic potential in live donor transplantation. Abe score could be successfully externally validated in the current study for the first time. In deceased donor transplantation, none of the analyzed scores was able to allow reliable prediction for the investigated study end-points.
Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center - Transplantation (IFB-Tx), Hannover Medical School, Germany.|Department of Trauma and Orthopaedic Surgery, Federal Armed Forces Hospital Westerstede, Westerstede, Germany.
Alexander
A
Kaltenborn
Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center - Transplantation (IFB-Tx), Hannover Medical School, Germany.|Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany.
Harald
H
Schrem
Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Medical Center Schleswig-Holstein (UKSH), Kiel Campus, Kiel, Germany.
Benedikt
B
Reichert
Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Medical Center Schleswig-Holstein (UKSH), Kiel Campus, Kiel, Germany.
Felix
F
Braun
Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany.
Nikos
N
Emmanouilidis
Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany.
Jürgen
J
Klempnauer
Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Medical Center Schleswig-Holstein (UKSH), Kiel Campus, Kiel, Germany.
Thomas
T
Becker
Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Medical Center Schleswig-Holstein (UKSH), Kiel Campus, Kiel, Germany.
Nils
N
Heits
hepatocellular carcinoma; liver transplantation; mortality; prediction; prognosis