Value of the SOFA Score As a Predictive Model for Short-term Survival in High-risk Liver Transplant Recipients with a Pre-transplant LabMELD Score ≥ 30

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2011 Dec 7

PMID 22143890

Citations 4

Authors

Harald Schrem

Melanie Reichert

Benedikt Reichert

Thomas Becker

Frank Lehner

Moritz Kleine

Huseyin Bektas

Kai Johanning

Christian P Strassburg

Jurgen Klempnauer

Affiliations

Soon will be listed here.

Abstract

Introduction: The Sequential Organ Failure Assessment (SOFA) score has been applied for the prediction of survival in critically ill patients. We analysed the value of the SOFA score for the prediction of short-term survival after liver transplantation in high-risk liver transplant recipients with a labMELD score ≥30.

Patients And Methods: We conducted a retrospective single-centre analysis including 88 consecutive liver transplants in adults between January 1, 2007 and December 31, 2010 with a pre-transplant labMELD score ≥30. The SOFA score was assessed preoperatively, directly after transplantation and on post-operative days (PODs) 1-10. Combined and living-related liver transplants were excluded. Receiver operating characteristic (ROC) curve analysis with the Hosmer-Lemeshow test and application of the Brier score were used to calculate sensitivity, specificity, overall model correctness and calibration. Cutoff values were selected with the best Youden index.

Results: ROC curve analysis showed areas under the curve (AUROCs) >0.8 for the SOFA score on PODs 1-10 for the prediction of hospital mortality, 30-day mortality and 3-month mortality with Hosmer-Lemeshow test results that confirmed good model calibration (p > 0.05). The Brier score demonstrated an accuracy of prediction (<0.25) of hospital mortality, 30-day mortality and 3-month mortality for the SOFA scores on PODs 4-9 indicating superior accuracy on PODs 7 and 8 with cutoff values for the SOFA score between 16.5 and 18.5. The pre-transplant SOFA score failed to reach AUROCs >0.7 (0.603-0.663) for the prediction of short-term survival.

Conclusions: Our results confirm the usefulness of the SOFA score in high-risk liver recipients during the early post-operative course, especially on PODs 7-8 for the prediction of hospital mortality, 30-day mortality and 3-month mortality and may be useful to predict futile early acute retransplantation.

Citing Articles

Prognostic Abilities and Quality Assessment of Models for the Prediction of 90-Day Mortality in Liver Transplant Waiting List Patients.

Saldana R, Schrem H, Barthold M, Kaltenborn A PLoS One. 2017; 12(1):e0170499.

PMID: 28129338 PMC: 5271345. DOI: 10.1371/journal.pone.0170499.

Matched-pair analysis: identification of factors with independent influence on the development of PTLD after kidney or liver transplantation.

Rausch L, Koenecke C, Koch H, Kaltenborn A, Emmanouilidis N, Pape L Transplant Res. 2016; 5:6.

PMID: 27486513 PMC: 4970231. DOI: 10.1186/s13737-016-0036-1.

Value and limitations of the BAR-score for donor allocation in liver transplantation.

Schrem H, Platsakis A, Kaltenborn A, Koch A, Metz C, Barthold M Langenbecks Arch Surg. 2014; 399(8):1011-9.

PMID: 25218679 DOI: 10.1007/s00423-014-1247-x.

Massive blood transfusion after the first cut in liver transplantation predicts renal outcome and survival.

Reichert B, Kaltenborn A, Becker T, Schiffer M, Klempnauer J, Schrem H Langenbecks Arch Surg. 2014; 399(4):429-40.

PMID: 24682384 DOI: 10.1007/s00423-014-1181-y.

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