Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Surgery (Statistics), University of Pittsburgh, Pittsburgh, PA, USA.
HPB (Oxford). 2021 Jun;23(6):927-936. doi: 10.1016/j.hpb.2020.10.002. Epub 2020 Nov 11.
We assessed if the risk of post-liver transplant mortality within 24 h could be stratified at the time of listing using the liver transplant risk score (LTRS). Secondary aims were to assess if the LTRS could stratify the risk of 30-day, 1-year mortality, and survival beyond the first year.
MELD, BMI, age, diabetes, and the need for dialysis were the five variables used to calculate the LTRS during patients' evaluation for liver transplantation. Mortality rates at 24 h, 30 days, and 1-year were compared among groups of patients with different LTRS. Patients with ABO-incompatibility, redo, multivisceral, partial graft and malignancies except for hepatocellular carcinoma were excluded. Data of 48,616 adult liver transplant recipients were extracted from the Scientific Registry of Transplant Recipients between 2002 and 2017.
24-h mortality was 0.9%, 1.0%, 1.1%, 1.7%, 2.3%, 2.0% and 3.5% for patients with LTRS of 0,1,2,3,4, 5 and ≥ 6, respectively (P < 0.001). 30-day mortality was 3.5%, 4.2%, 4.9%, 6.2%, 7.6%, 7.2% and 10.1% respectively (P < 0.001). 1-year mortality was 8.6%, 10.8%, 12.9%, 13.9%, 18.5%, 20.3% and 28.6% respectively (P < 0.001). 10-year survival was 61%, 56%, 57%, 54%, 47%, and 31% for patients with 0, 1, 2, 3, 4, 5 and ≥ 6 points respectively (P < 0.001).
Perioperative mortality and long-term survival of patients undergoing LT can be accurately estimated at the time of listing by the LTRS.
本研究旨在评估在进行肝移植时，使用肝移植风险评分（LTRS）是否可以在 24 小时内对术后死亡风险进行分层。次要目的是评估 LTRS 是否可以分层 30 天、1 年死亡率以及 1 年以上的生存率。
在评估患者进行肝移植时，MELD、BMI、年龄、糖尿病和透析需求这五个变量用于计算 LTRS。比较不同 LTRS 分组患者的 24 小时、30 天和 1 年死亡率。排除 ABO 不相容、再次移植、多器官、部分移植物和除肝细胞癌以外的恶性肿瘤患者。本研究从 2002 年至 2017 年从 Scientific Registry of Transplant Recipients 中提取了 48616 例成人肝移植受者的数据。
LTRS 为 0、1、2、3、4、5 和≥6 的患者，其 24 小时死亡率分别为 0.9%、1.0%、1.1%、1.7%、2.3%、2.0%和 3.5%（P<0.001）。30 天死亡率分别为 3.5%、4.2%、4.9%、6.2%、7.6%、7.2%和 10.1%（P<0.001）。1 年死亡率分别为 8.6%、10.8%、12.9%、13.9%、18.5%、20.3%和 28.6%（P<0.001）。LTRS 为 0、1、2、3、4、5 和≥6 的患者 10 年生存率分别为 61%、56%、57%、54%、47%、31%（P<0.001）。
LTRS 可在肝移植患者进行肝移植时准确评估围手术期死亡率和长期生存率。
