Scoring Short-term Mortality after Liver Transplantation

• Main Authors: Chung-Shun Wong, 王忠信
• Other Authors: Yung-Chang Chen
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/85342777182745881630

碩士 === 國立陽明大學 === 急重症醫學研究所 === 98 === Aim: To evaluate and compare the accuracy of Child-Pugh points, model for end-stage liver disease (MELD), the Sequential Organ Failure Assessment (SOFA) score and RIFLE (risk of renal dysfunction, injury to the kidney, failure of the kidney, loss of kidney function and end-stage kidney disease) criteria for predicting 3-month and 1-year mortality in post-liver transplant patients. Methods and Materials: This study retrospectively reviewed medical records of 149 patients who had received liver transplants in a tertiary care university hospital from January, 2000 to December, 2007. Demographic, clinical, and laboratory variables were recorded. Each patient was assessed by four scoring systems before transplant and on post-operation days 1, 3, 7 and 14. Results: The overall 1-year post-transplant survival rate was 77.9%. The SOFA score had better discriminatory power than Child-Pugh points, MELD, and RIFLE criteria. Moreover, SOFA score on Day 7 post-liver transplant had the best Youden index and highest overall correctness of prediction for 3-month (0.86, 93%) and 1-year mortality (0.62, 81%). Cumulative survival rates at 1-year follow-up after liver transplantation differed significantly (p<0.001) between patients who had SOFA score < 7 on post-liver transplant day 7 and those who had SOFA score >7 on post-liver transplant day 7. Conclusions: Of the four evaluated scoring systems, only the SOFA scores calculated before liver transplantation were statistically significant predictors of 3-month and 1-year post-transplant mortality. SOFA on post-liver transplant Day 7 had the best discriminative power for predicting 3-month and 1-year mortality after liver transplantation.