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21 May 2009

Assessment of a novel prognostic index in prediction of early mortality after liver transplantation

J Raszeja-Wyszomirska, M Wasilewicz, B Szymanik, E Wunsch, K Jarosz, M Wójcicki, P Milkiewicz

Ann Transplant 2009; 14(1): 40-40 :: ID: 880342

Abstract

Background: The Model of End Stage Liver Disease (MELD) predicts mortality on the transplant list, however it is not of a much use in predicting post-transplant outcome. Several prognostic models (PM) have been tested in patients with cirrhosis, nevertheless their predictive value in post-transplant setting has not been established. We have recently designed a novel PM based on a Child-Pugh-Turcotte score and creatinine levels (CPT+Crea), which proved to be useful in patients with cirrhosis (Wunsch et al Gastroent Pol 2008). Aim: Retrospective analysis of the prediction of early (1 month) mortality with CPT+Crea and five other PM in patients, who underwent liver transplantation (LTx) in our centre.
Material/Methods: Forty eight consecutive patients (30 males, 18 females, mean age 51 years) were included. Predictive value of CPT+Crea was compared with Child-Pugh-Turcotte score (CPT), CPT in Huo modification (CPTHuo) (Huo et al Liver Transpl 2006), CPT+Na, MELD and MESO. Pearson correlation and ROC curves/area under the curve (AUC) were determined for each index. P values <0.05 were considered significant.
Results: CPT-Crea showed the highest correlation with the risk of death (r=0.368, p=0.01) and MELD and MESO the lowest (r=0.204, p=NS and r=0.254, p=NS respectively). Also ROC analysis showed the best predictive value of CPT-Crea with AUC of 0.748 as compared to 0.689 for MESO and 0.659 for MELD.
Conclusions: A novel index based on Child-Pugh-Turcotte score and creatinine levels is a significantly better predictor of early death after LTx than already used scores. Its usefulness should be validated in a prospective trial and a larger cohort of patients.

Keywords: Liver Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358