Re-evaluation of the predictive score for 6-month graft survival in living donor liver transplantation in the modern era

Tomoharu Yoshizumi, Toru Ikegami, Yuki Bekki, Mizuki Ninomiya, Hideaki Uchiyama, Tomohiro Iguchi, Yo Ichi Yamashita, Hirofumi Kawanaka, Ken Shirabe, Yoshihiko Maehara

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Abstract

The limitations of donor age, graft size, and the Model for End-Stage Liver Disease (MELD) score have not been apparent in living donor liver transplantation (LDLT). Our team developed a formula for predicting graft survival after LDLT; the formula includes the graft weight, donor age, MELD score, and portosystemic shunt status. The aims of this study were to re-evaluate the reliability of our formula and to assess whether our modified treatment strategy has improved 6-month graft survival. Two hundred seventeen patients were allocated into 2 groups: patients with predictive scores ≥ 1.30 (n = 162) and patients with predictive scores < 1.30 (n = 55). The latter group was also divided into subgroups of patients with scores of 1.15 to 1.30 (n = 37) and patients with scores < 1.15 (n = 18). Survival rates for patients with scores < 1.30 were significantly worse than rates for patients with scores ≥ 1.30 (P = 0.006). Survival rates for patients with scores < 1.15 were significantly worse than rates for patients with scores of 1.15 to <1.30 (P < 0.001). A multivariate analysis showed that a predictive score < 1.15 (odds ratio = 7.87, P = 0.006) and a body mass index ≥ 30 kg/m 2 (odds ratio = 13.3, P < 0.001) were independent risk factors for 6-month graft mortality. In conclusion, predictive scores reliably predict 6-month graft survival and could allow a widening of the safe ranges for donor ages and graft sizes.

Original languageEnglish
Pages (from-to)323-332
Number of pages10
JournalLiver Transplantation
Volume20
Issue number3
DOIs
Publication statusPublished - Mar 1 2014

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

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    Yoshizumi, T., Ikegami, T., Bekki, Y., Ninomiya, M., Uchiyama, H., Iguchi, T., Yamashita, Y. I., Kawanaka, H., Shirabe, K., & Maehara, Y. (2014). Re-evaluation of the predictive score for 6-month graft survival in living donor liver transplantation in the modern era. Liver Transplantation, 20(3), 323-332. https://doi.org/10.1002/lt.23804