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eISSN: 2329-0358

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Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation.
Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time... read more

Published: 2021-06-11



Sequential Organ Failure Assessment (SOFA) Score-Based Factors Predict Early Mortality in High-Risk Patients with Living Donor Liver Transplant

Hao-Chien Hung, Chin-Hsin Shen, Chen-Fang Lee, Ssu-Min Cheng, Wei-Chen Lee

Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan

Ann Transplant 2021; 26:e931045

DOI: 10.12659/AOT.931045

BACKGROUND: Patients with a Sequential Organ Failure Assessment (SOFA) score >7 on post-transplant day (POD) 7 have been reported to have a higher risk of short-term mortality after living donor liver transplant (LDLT). We sought to identify factors that were associated with early mortality in this high-risk population.
MATERIAL AND METHODS: A total of 102 patients with a high SOFA score (>7) on POD 7 were enrolled, of which 72 (70.6%) were assigned to the survivor group, and the other 30 (29.4%) patients were assigned to the non-survivor group according to post-transplant 3-month results. Demographics, clinical data, operative parameters, and individual SOFA component scores were collected. Independent risk factors for 3-month mortality were identified by multivariate logistic regression analysis using backward elimination procedures.
RESULTS: Of 102 high SOFA score patients, the 3-month mortality rate after LDLT in our study was 29.4%. Four independent risk factors were indicative for early death: graft-to-recipient weight ratio (GRWR) <0.8 (hazard ratio [HR]=3.00; 95% CI=1.05-8.09; P=0.041), longer warm ischemia time (HR=37.84; 95% CI=1.63-880.77; P=0.024), high liver component of the SOFA score, and cardiovascular component of the SOFA score (liver component: HR=10.39; 95% CI=1.77-60.89; P=0.009 and cardiovascular component: HR=13.34; 95% CI=2.22-80.12; P=0.005).
CONCLUSIONS: In conclusion, 3-month mortality among patients with high SOFA score on POD 7 is associated with multiple independent risk factors, including smaller GRWR, longer warm ischemia time, and higher category of liver and cardiovascular component of SOFA score. By recognizing high-risk patients earlier, the LDLT outcomes may be improved by timely intensive therapies.

Keywords: Liver Transplantation, Risk Factors, Survival Analysis

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Jia Xu, Yedong Yu, Junhao Lv, Sisi Yang, Jianyong Wu, Jianghua Chen, Wenhan Peng

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DOI: 10.12659/AOT.931059

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Ann Transplant 2021; 26:e931832

DOI: 10.12659/AOT.931832