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| A good prognostic predictor for liver transplantation recipients with benign end-stage liver cirrhosis |
| Qiang Wei, Rahmeet Singh Nemdharry, Run-Zhou Zhuang, Jie Li, Qi Ling, Jian Wu, Tian Shen, Lin Zhou, Hai-Yang Xie, Min Zhang, Xiao Xu and Shu-Sen Zheng |
Hangzhou, China
Author Affiliations: Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China (Wei Q, Nemdharry RS, Zhuang RZ, Li J, Ling Q, Wu J, Shen T, Zhou L, Xie HY, Zhang M, Xu X and Zheng SS); Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China (Xu X and Zheng SS)
Corresponding Author: Prof. Shu-Sen Zheng, MD, PhD, FACS, Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, China (Tel/Fax: +86-571-87236567; E-mail: zyzss@zju.edu.cn) |
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Abstract BACKGROUND: Post-transplant model for predicting mortality (PMPM, calculated as -5.359+1.988×ln (serum creatinine[mg/dL])+1.089×ln (total bilirubin [mg/dL])) score has been proved to be a simple and accurate model for predicting the prognosis after liver transplantation (LT) in a single center study. Here we aim to verify this model in a large cohort of patients.
METHODS: A total of 2727 patients undergoing LT with end-stage liver cirrhosis from January 2003 to December 2010 were included in this retrospective study. Data were collected from the China Liver Transplant Registry (CLTR). PMPM score was calculated at 24-h and 7-d following LT. According to the PMPM score at 24-h, all patients were divided into the low-risk group (PMPM score ≤-1.4, n=2509) and the high-risk group (PMPM score >-1.4, n=218). The area under receiver operator characteristic curve (AUROC) was calculated for evaluating the prognostic accuracy.
RESULTS: The 1-, 3-, and 5-year patient survival rates in the low-risk group were significantly higher than those in the high-risk group (90.23%, 88.01%, and 86.03% vs 63.16%, 59.62%, and 56.43%, respectively, P<0.001). In the high-risk group, 131 patients had a decreased PMPM score (≤-1.4) at 7-d, and their cumulative survival rate was significantly higher than the other 87 patients with sustained high PMPM score (>-1.4) (P<0.001). For predicting 3-month mortality, PMPM score showed a much higher AUROC than post-transplant MELD score (P<0.05).
CONCLUSION: PMPM score is a simple and effective tool to predict short-term mortality after liver transplantation in patients with benign liver diseases, and an indicator for prompt salvaging treatment as well.
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2017, Vol. 16 
