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A New Score to Predict Recipient Mortality from Preoperative Donor and Recipient Characteristics in Living Donor Liver Transplantation (DORMAT Score)

Raghavendra Babu, Pulkit Sethi, Sudhindran Surendran, Puneet Dhar, Unnikrishnan Gopalakrishnan, Dinesh Balakrishnan, Ramachandran Narayana Menon, Binoj Sivasankarapillai Thankamonyamma, Sudheer Othiyil Vayoth, Manoj Thillai

(Department of Gastrointestinal Surgery and Solid Organ Transplantation, Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University), Ponekkara, Kochi, Kerala, India)

Ann Transplant 2017; 22:499-506

DOI: 10.12659/AOT.904350

BACKGROUND: Recipient outcomes in adult living donor liver transplantation depend on various characteristics in both recipient and donor. We aimed to derive a score based upon preoperative characteristics in donor and recipient that could predict the recipient mortality in adult living donor liver transplantation.
MATERIAL AND METHODS: Retrospective data of 100 living donor liver transplantation recipients and their respective donors were analyzed for preoperative factors that correlated with recipient mortality. Statistically significant factors were weighted appropriately to derive a regression equation to obtain a donor-to-recipient match (DORMAT) score. This score was applied to 71 patients prospectively and their outcome was analyzed.
RESULTS: Donor-recipient match (DORMAT) score, derived using regression analysis of the significant variables was [0.002 (Recipient age) + 0.013 (Recipient BMI) + 0.055 (SBP) + 0.344 (HRS) + 0.022 (Pre-op culture positivity) + 0.01 (Donor age) – 0.639]×100. DORMAT score, when validated to a prospective cohort of 71 adult-to-adult LDLT patients, had a C-statistic (area under ROC curve) of 0.712. The mortality rate was seen to increase with increasing DORMAT score.
CONCLUSIONS: DORMAT score is a useful clinical decision-making tool to predict recipient mortality in adult living donor liver transplantation.

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