Toledo Enrique, Castanedo Sonia, Tolaretxipi Erik G, Lozano Ana, Echeverri Juan, Fernández-Santiago Roberto, Anderson Edward J, Castillo Federico, Rodríguez-Sanjuan Juan Carlos
General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Transplant Proc. 2020 Jun;52(5):1481-1485. doi: 10.1016/j.transproceed.2020.02.059. Epub 2020 Mar 26.
The Balance of Risk (BAR) score is a simple test that combines donor and recipient variables to predict liver transplant success. It has been validated in different publications, with cut-off points of between 15 and 18 points proposed depending on the region. The aim of this study is to test the validity of the BAR score and to find the optimal cut-off point for our population.
A retrospective cohort of 164 liver transplant patients was selected between January 2012 and July 2019. All were older than 18 years and were treated in a Spanish tertiary-level hospital.
The receiver operating characteristic curve between BAR and 5-year survival yields a result of 0.622 (P = .046), placing the cut-off point at ≥7 (sensitivity 61.5%, specificity 61.6%). Patients with a BAR score <7 and a BAR score ≥7 have an estimated 5-year survival of 53.91 vs 47.51 months, respectively (log rank = .032). The only 2 variables associated with increased survival were a BAR score of <7 (hazard ratio = 2.566; P < .001) and a body mass index <30 (hazard ratio = 6.667; P < .001).
A low BAR score correlates well with liver transplant survival at 5 years. The BAR is a simple tool that should be used for donor-recipient matching. Due to the characteristics, resources, and population in our environment, a BAR score of 7 would be the optimum cut-off point for a liver transplant.
风险平衡（BAR）评分是一种简单的测试，它结合了供体和受体变量来预测肝移植的成功率。该评分已在不同的出版物中得到验证，根据地区不同，建议的临界值在15至18分之间。本研究的目的是检验BAR评分的有效性，并为我们的人群找到最佳临界值。
选取2012年1月至2019年7月期间164例肝移植患者的回顾性队列。所有患者年龄均超过18岁，且在西班牙一家三级医院接受治疗。
BAR评分与5年生存率之间的受试者工作特征曲线结果为0.622（P = 0.046），临界值设定为≥7（敏感性61.5%，特异性61.6%）。BAR评分<7和BAR评分≥7的患者估计5年生存率分别为53.91个月和47.51个月（对数秩检验=0.032）。与生存率增加相关的仅有的两个变量是BAR评分<7（风险比=2.566；P < 0.001）和体重指数<30（风险比=6.667；P < 0.001）。
低BAR评分与肝移植5年生存率密切相关。BAR是一种应在供体-受体匹配中使用的简单工具。鉴于我们环境中的特征、资源和人群，BAR评分为7将是肝移植的最佳临界值。
