학술논문

Proposal and validation of a liver graft discard score for liver transplantation from deceased donors: a multicenter Italian study
Document Type
Academic Journal
Source
Updates in Surgery. April, 2022, Vol. 74 Issue 2, p491, 10 p.
Subject
Liver -- Transplantation
Language
English
Abstract
Several studies have explored the risk of graft dysfunction after liver transplantation (LT) in recent years. Conversely, risk factors for graft discard before or at procurement have poorly been investigated. The study aimed at identifying a score to predict the risk of liver-related graft discard before transplantation. Secondary aims were to test the score for prediction of biopsy-related negative features and post-LT early graft loss. A total of 4207 donors evaluated during the period January 2004-Decemeber 2018 were retrospectively analyzed. The group was split into a training set (n = 3,156; 75.0%) and a validation set (n = 1,051; 25.0%). The Donor Rejected Organ Pre-transplantation (DROP) Score was proposed: - 2.68 + (2.14 if Regional Share) + (0.03*age) + (0.04*weight)-(0.03*height) + (0.29 if diabetes) + (1.65 if anti-HCV-positive) + (0.27 if HBV core) - (0.69 if hypotension) + (0.09*creatinine) + (0.38*log10AST) + (0.34*log10ALT) + (0.06*total bilirubin). At validation, the DROP Score showed the best AUCs for the prediction of liver-related graft discard (0.82; p < 0.001) and macrovesicular steatosis [greater than or equal to] 30% (0.71; p < 0.001). Patients exceeding the DROP 90th centile had the worse post-LT results (3-month graft loss: 82.8%; log-rank P = 0.024).The DROP score represents a valuable tool to predict the risk of liver function-related graft discard, steatosis, and early post-LT graft survival rates. Studies focused on the validation of this score in other geographical settings are required.
Author(s): Quirino Lai [sup.1], Davide Ghinolfi [sup.2], Alfonso W. Avolio [sup.3], Tommaso M. Manzia [sup.4], Gianluca Mennini [sup.1], Fabio Melandro [sup.2], Francesco Frongillo [sup.3], Marco Pellicciaro [sup.4], Zoe Larghi Laureiro [...]