E-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation

Overview

Journal Ann Surg Open

Publisher Wolters Kluwer

Specialty General Surgery

Date 2023 Dec 25

PMID 38144498

Authors

Viniyendra Pamecha

Nilesh Sadashiv Patil

Tharun Gattu

Guresh Kumar

Bramhadatta Pattnaik

Nihar Mohapatra

Gaurav Sindwani

Ashok Choudhury

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to analyze risk factors and develop a predictive model for early allograft loss due to early graft dysfunction (EGD) in adult live-donor liver transplantation (LDLT).

Methods: Data of patients who underwent LDLT from 2011 to 2019 were reviewed for EGD, associated factors, and outcomes. A homogeneous group of 387 patients was analyzed: random cohort A (n = 274) for primary analysis and random cohort B (n = 113) for validation.

Results: Of 274 recipients, 92 (33.6%) developed EGD. The risk of graft loss within 90 days was 29.3% and 7.1% in those with and without EGD, respectively ( < 0.001). Multivariate logistic regression analysis determined donor age ( 0.045), estimated (e) graft weight ( 0.001), and the model for end-stage liver disease (MELD) score (0.001) as independent predictors of early graft loss due to EGD. Regression coefficients of these factors were employed to formulate the risk model: Predicted (P) early graft loss risk (e-GLR) score = 10 × [(donor age × 0.052) + (e-Graft weight × 1.681) + (MELD × 0.145)] - 8.606 (e-Graft weight = 0, if e-Graft weight ≥640 g and e-Graft weight = 1, and if e-Graft weight < 640 g). Internal cross-validation revealed a high predictive value (C-statistic = 0.858).

Conclusions: Our novel risk score can efficiently predict early allograft loss following graft dysfunction, which enables donor-recipient matching, evaluation, and prognostication simply and reliably in adult LDLT.

Citing Articles

Perspectives and Tools in Liver Graft Assessment: A Transformative Era in Liver Transplantation.

Safi K, Pawlicka A, Pradhan B, Sobieraj J, Zhylko A, Struga M Biomedicines. 2025; 13(2).

PMID: 40002907 PMC: 11852418. DOI: 10.3390/biomedicines13020494.

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