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A simple scoring model for predicting early graft failure and postoperative mortality after liver transplantation

Diaz-Nieto, R; Lykoudis, P; Robertson, F; Sharma, D; Moore, K; Malago, M; Davidson, BR; (2019) A simple scoring model for predicting early graft failure and postoperative mortality after liver transplantation. Annals of Hepatology 10.1016/j.aohep.2019.06.008. (In press). Green open access

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Abstract

Introduction and objectives: Graft failure and postoperative mortality are the most serious complications after liver transplantation. The aim ofthis study is to establish a prognostic scoring system to predict graft and patient survival based on serum transaminases levels that are routinely used during the postoperative period in human cadaveric liver transplants. Patients and methods: Postoperative graftfailure and patient mortality after liver transplant were analyzed from a consecutive series of 1299 patients undergoing cadaveric liver transplantation. This was correlated with serum liver function tests and the rate of reduction in transaminase levels over the first postoperative week. A cut-off transaminase level correlating with graft and patient survival was calculated and incorporated into a scoring system. Results: Aspartate-aminotransferase (AST) on postoperative day one showed significant correlation with early graft failure for levels above 723 U/dl and early postoperative mortality for levels above 750 U/dl. AST reduction rate (day 1 to 3) greater than 1.8 correlated with reduced graft failure and greater than 2 with mortality. Alanine-aminotransferase (ALT) reduction in the first 48 h post transplantation also correlated with outcomes. Conclusion: A scoring system with these three variables allowed us to classify our patients into three groups of risk for early graft failure and mortality.

Type: Article
Title: A simple scoring model for predicting early graft failure and postoperative mortality after liver transplantation
Location: Mexico
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.aohep.2019.06.008
Publisher version: https://doi.org/10.1016/j.aohep.2019.06.008
Language: English
Additional information: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: MaDiRe test, Organ failure, Primary non-function, Transaminases, Liver function, Liver transplantation
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Education
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10085717
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