TY - JOUR
T1 - A novel scoring system to predict short-term mortality after living donor liver transplantation for acute liver failure
AU - Vanguard Multicenter Study of International Living Donor Liver Transplantation (iLDLT) group
AU - Shimata, Keita
AU - Yoon, Young In
AU - Hibi, Taizo
AU - Morinaga, Jun
AU - Narayanan, Anila Kutty
AU - Toshima, Takeo
AU - Ito, Takashi
AU - Akamatsu, Nobuhisa
AU - Kotera, Yoshihito
AU - Hong, Suk Kyun
AU - Hasegawa, Yasushi
AU - Umeda, Yuzo
AU - Reddy, Mettu Srinivas
AU - Ong, Aldwin De Leon
AU - Sivaprasadan, Saraswathy
AU - Varghese, Joy
AU - Sugawara, Yasuhiko
AU - Chen, Chao Long
AU - Nakayama, Nobuaki
AU - Mochida, Satoshi
AU - Tanaka, Atsushi
AU - Suh, Kyung Suk
AU - Ikegami, Toru
AU - Lee, Kwang Woong
AU - Lee, Sung Gyu
AU - Sudhindran, Surendran
AU - Yoshizumi, Tomoharu
AU - Hatano, Etsuro
AU - Okumura, Shinya
AU - Hasegawa, Kiyoshi
AU - Egawa, Hiroto
AU - Obara, Hideaki
AU - Yasui, Kazuya
AU - Ogura, Yasuhiro
AU - Jobara, Kanta
AU - Nitta, Hiroyuki
AU - Katagiri, Hirokatsu
AU - Otsuka, Masayuki
AU - Kuboki, Satoshi
AU - Eguchi, Susumu
AU - Hara, Takanobu
AU - Eguchi, Hidetoshi
AU - Sasaki, Kazuki
AU - Aoki, Taku
AU - Ohdan, Hideki
AU - Ohira, Masahiro
AU - Takada, Yasutsugu
AU - Ogawa, Kohei
AU - Fukumoto, Takumi
AU - Kuramitsu, Kaori
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/10
Y1 - 2024/10
N2 - Liver transplantation is often the only lifesaving option for acute liver failure (ALF); however, the predictors of short-term mortality (death within one year) after living donor liver transplantation (LDLT) for ALF have yet to be defined. We retrospectively collected patients ≥18 years old who underwent LDLT for ALF between 2010 and 2020 at 35 centers in Asia. Univariate and multivariate logistic regression analyses were conducted to identify the clinical variables related to short-term mortality and establish a novel scoring system. The Kaplan-Meier method was performed to explore the association between the score and overall survival. Of the 339 recipients, 46 (13.6%) died within 1 year after LDLT. Multivariate analyses revealed 4 independent risk factors for death: use of vasopressors or mechanical ventilation, the higher model for end-stage liver disease score, and a lower graft-to-recipient weight ratio. The internally validated c-statistic of the short-term mortality after transplant (SMT) score derived from these 4 variables was 0.80 (95% confidence interval: 0.74-0.87). The SMT score successfully stratified recipients into low-, intermediate-, and high-risk groups with 1-year overall survival rates of 96%, 80%, and 50%, respectively. In conclusion, our novel SMT score based on 4 predictors will guide ALF recipient and living donor selection.
AB - Liver transplantation is often the only lifesaving option for acute liver failure (ALF); however, the predictors of short-term mortality (death within one year) after living donor liver transplantation (LDLT) for ALF have yet to be defined. We retrospectively collected patients ≥18 years old who underwent LDLT for ALF between 2010 and 2020 at 35 centers in Asia. Univariate and multivariate logistic regression analyses were conducted to identify the clinical variables related to short-term mortality and establish a novel scoring system. The Kaplan-Meier method was performed to explore the association between the score and overall survival. Of the 339 recipients, 46 (13.6%) died within 1 year after LDLT. Multivariate analyses revealed 4 independent risk factors for death: use of vasopressors or mechanical ventilation, the higher model for end-stage liver disease score, and a lower graft-to-recipient weight ratio. The internally validated c-statistic of the short-term mortality after transplant (SMT) score derived from these 4 variables was 0.80 (95% confidence interval: 0.74-0.87). The SMT score successfully stratified recipients into low-, intermediate-, and high-risk groups with 1-year overall survival rates of 96%, 80%, and 50%, respectively. In conclusion, our novel SMT score based on 4 predictors will guide ALF recipient and living donor selection.
KW - artificial liver support
KW - graft-to-recipient weight ratio
KW - model for end-stage liver disease
KW - prognosis
KW - scoring system
UR - http://www.scopus.com/inward/record.url?scp=85200995375&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85200995375&partnerID=8YFLogxK
U2 - 10.1016/j.ajt.2024.04.016
DO - 10.1016/j.ajt.2024.04.016
M3 - Article
C2 - 38692411
AN - SCOPUS:85200995375
SN - 1600-6135
VL - 24
SP - 1857
EP - 1867
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 10
ER -