Scoring systems for predicting mortality after liver transplantation

Heng Chih Pan, Chang Chyi Jenq, Wei Chen Lee, Ming Hung Tsai, Pei Chun Fan, Chih Hsiang Chang, Ming Yang Chang, Ya Chung Tian, Cheng Chieh Hung, Ji Tseng Fang, Chih Wei Yang, Yung Chang Chen

Research output: Contribution to journalJournal Article peer-review

24 Scopus citations

Abstract

Background: Liver transplantation can prolong survival in patients with end-stage liver disease. We have proposed that the Sequential Organ Failure Assessment (SOFA) score calculated on post-transplant day 7 has a great discriminative power for predicting 1-year mortality after liver transplantation. The Chronic Liver Failure - Sequential Organ Failure Assessment (CLIF-SOFA) score, a modified SOFA score, is a newly developed scoring system exclusively for patients with end-stage liver disease. This study was designed to compare the CLIF-SOFA score with other main scoring systems in outcome prediction for liver transplant patients. Methods:We retrospectively reviewed medical records of 323 patients who had received liver transplants in a tertiary care university hospital from October 2002 to December 2010. Demographic parameters and clinical characteristic variables were recorded on the first day of admission before transplantation and on post-transplantation days 1, 3, 7, and 14. Results:The overall 1-year survival rate was 78.3% (253/323). Liver diseases were mostly attributed to hepatitis B virus infection (34%). The CLIF-SOFA score had better discriminatory power than the Child-Pugh points, Model for End-Stage Liver Disease (MELD) score, RIFLE (risk of renal dysfunction, injury to the kidney, failure of the kidney, loss of kidney function, and end-stage kidney disease) criteria, and SOFA score. The AUROC curves were highest for CLIF-SOFA score on post-liver transplant day 7 for predicting 1-year mortality. The cumulative survival rates differed significantly for patients with a CLIF-SOFA score <8 and those with a CLIF-SOFA score >8 on post-liver transplant day 7. Conclusion: The CLIF-SOFA score can increase the prediction accuracy of prognosis after transplantation. Moreover, the CLIF-SOFA score on post-transplantation day 7 had the best discriminative power for predicting 1-year mortality after liver transplantation.

Original languageEnglish
Article numbere107138
JournalPLoS ONE
Volume9
Issue number9
DOIs
StatePublished - 09 2014

Bibliographical note

Publisher Copyright:
© 2014 Pan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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