Survival outcomes following liver retransplantation (reSOFT) score: A model predicting survival after adult liver retransplantation.

IF 4.7 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Liver Transplantation Pub Date : 2025-07-01 Epub Date: 2024-12-17 DOI:10.1097/LVT.0000000000000549
Vivian Terry, Caroline Christmann, Spoorthi Kamepalli, Ashley Montgomery, John Goss, Abbas Rana
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引用次数: 0

Abstract

Recipient and donor risk factors impacting adult liver retransplantation remain inadequately described in the modern era of liver transplantation. Our study aimed to develop a risk model for 3-month recipient survival following liver retransplantation using data from the Organ Procurement and Transplantation Network's (OPTN) liver transplantation database. We conducted univariate and multivariable analyses on 6660 adult patients who underwent liver retransplantation between 2002 and 2023. Multiple imputation was also conducted to account for missing variables. From our analysis, we identified 14 recipient factors, 1 donor factor (age), and 1 operative factor (cold ischemia time) that significantly impacted 3-month patient survival. Among the most significant risk factors were a functional status, measured by the Karnofsky Score, of 10% at retransplantation (OR: 1.80, 95% CI: 1.44-2.24) and recipient albumin of <1.5 (OR: 1.76, CI: 1.12-2.77). The most significant protective factors included a functional status of 90% (OR: 0.22, CI: 0.07-0.70) and recipients with a history of HCC (OR: 0.10, CI: 0.01-0.79). The reSOFT score was developed by assigning points to these factors proportional to their hazard ratios and divided into high-, moderate-, and low-risk groups that accurately predict 3-month survival post-retransplant. With a C-statistic of 0.73 (CI: 0.71-0.75), this tool may serve to guide clinicians in identifying and better caring for high-risk retransplant recipients.

肝脏再移植术后生存结果(reSOFT)评分:预测成人肝脏再移植术后存活率的模型。
在现代肝移植时代,受体和供体影响成人肝脏再移植的风险因素仍未得到充分描述。我们的研究旨在利用器官获取和移植网络(OPTN)肝脏移植数据库的数据,建立肝脏再移植后受者3个月存活率的风险模型。我们对2002年至2023年间接受肝脏再移植的6660名成年患者进行了单变量和多变量分析。我们还对缺失变量进行了多重估算。通过分析,我们发现14个受体因素、1个供体因素(年龄)和1个手术因素(低温缺血时间)对患者3个月的存活率有显著影响。其中最重要的风险因素是再移植时功能状态(以 Karnofsky 评分衡量)达到 10%(OR:1.80,95% CI:1.44-2.24)和受体白蛋白低于 1.5(OR:1.76,CI:1.12-2.77)。最重要的保护因素包括功能状态达到 90%(OR:0.22,CI:0.07-0.70)和受者有肝细胞癌病史(OR:0.10,CI:0.01-0.79)。reSOFT 评分是根据这些因素的危险比按比例赋分后得出的,分为高、中、低风险组,可准确预测移植后 3 个月的存活率。该工具的C统计量为0.73(CI为0.71-0.75),可用于指导临床医生识别和更好地照顾高风险再移植受者。
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来源期刊
Liver Transplantation
Liver Transplantation 医学-外科
CiteScore
7.40
自引率
6.50%
发文量
254
审稿时长
3-8 weeks
期刊介绍: Since the first application of liver transplantation in a clinical situation was reported more than twenty years ago, there has been a great deal of growth in this field and more is anticipated. As an official publication of the AASLD, Liver Transplantation delivers current, peer-reviewed articles on liver transplantation, liver surgery, and chronic liver disease — the information necessary to keep abreast of this evolving specialty.
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