BAR Score Performance in Predicting Survival after Living Donor Liver Transplantation: A Single-Center Retrospective Study.

Talaat Zakareya,Mohamed Abbasy,Mohammad Taha,Hassan Elzohry,Hazem Zakaria,Mostafa Elhelbawy,Mohamed Deif,Reda Aglan,Ehab Darwiesh,Kevork M Peltekian

doi:10.1155/2022/2877859

Abstract

Methods 146 adult liver transplant recipients were included. Univariate and multivariate analyses were used to determine the independent predictors of survival at 3 months, 1 year, and 5 years. The receiver operating characteristic (ROC) curve for the BAR score was plotted, and the area under the ROC curve (AUROC) was calculated. Kaplan–Meier curve and log-rank test were used to compare survival above and below the best cutoff values. Results The mean age was 52.45 ± 8.54 years, and 59.6% were males. The survival rates were 89, 78.8, and 72% at 3 months, 1 year, and 5 years, respectively. The BAR score demonstrated a clinically significant value in the prediction of 3-month (AUROC = 0.89), 1-year (AUROC = 0.76), and 5-year survival (AUROC = 0.71). Among the investigated factors associated with survival, BAR score <10 points was the only independent predictor of 3-month (OR 7.34, p < 0.0001), 1-year (OR 3.37, p=0.001), and 5-year survival (OR 2.83, p=0.044). Conclusions BAR is a simple and easily applicable scoring system that could significantly predict short- and long-term survival after LDLT. A large multicenter study is warranted to validate our results in the Egyptian population.

Highlights

Liver transplantation provides a curative treatment for most end-stage liver diseases
Cultural, and traditional beliefs, only Living donor liver transplantation (LDLT) is legalized by Egyptian law whereas deceased donor liver transplantation (DDLT) is prohibited [3]
A receiver operating characteristic (ROC) curve was plotted for the balance of risk (BAR) score. e power of the BAR score to predict mortality at 3 months, 1 year, and 5 years was reflected by the area under the ROC curve (AUROC)

Summary

Introduction

Liver transplantation provides a curative treatment for most end-stage liver diseases. Given the increasing demand for liver transplantation, deceased organs are not sufficient enough to meet this increasing demand. Living donor liver transplantation (LDLT) provides an alternative to overcome this organ shortage [1]. The first liver transplantation in Egypt was performed in 1991 at the National Liver Institute, Menoufia University [2]. The liver transplantation program has expanded gradually over the past years. We have around 300 transplants performed at 13 centers across the country each year. Cultural, and traditional beliefs, only LDLT is legalized by Egyptian law whereas deceased donor liver transplantation (DDLT) is prohibited [3]. Complications of hepatitis C virus (HCV) infection represent the leading indication for liver transplantation in Egypt. Several factors affect survival, including recipient, donor, surgical, and perioperative factors [4]

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