Abstract
Liver transplantation is the treatment of choice for patients with terminal liver disease. The Balance of Risk Score (BAR), Survival Outcomes Following Liver Transplantation (SOFT) and Donor Risk Index (DRI) scores are predictive systems for post-transplant survival. To evaluate the most accurate score and the best cutoff point for each predictor in the brazilian population. Retrospective cross-sectional study of 177 patients. Data on the recipient, donor and transplant were analyzed and the prognostic scores BAR, SOFT and DRI were calculated for each transplant. To determine the BAR and SOFT cutoff points associated with death in three months, ROC curves were adjusted. Results : The best cutoff point for BAR was 9 points with an area under the ROC curve=0.69 and for SOFT it was 12 points with an area under the ROC curve=0.73. The DRI score did not discriminate survival (p = 0.139). The SOFT score proved to be better than BAR for survival analysis post-hepatic transplantation and the DRI was not effective.
Highlights
The liver transplantation is the chosen treatment to patients that have end stage liver disease 1
Using the score Model for End-Stage Liver Disease (MELD) we can estimate the severity of the cirrhotic patient and the mortality rate on waitlist, and recently this has been the base for the organ allocating system . 9,10
Determinants to survival after transplant were the following variables: Balance of Risk Score (BAR) score >9 (HR 2.58; confidence interval (CI) 95% 1.50–4.41; p=0.001), Survival Outcomes Following Liver Transplantation (SOFT) score >12 (HR 3.22; CI 95% 1.97–5.53; p 35 points
Summary
The liver transplantation is the chosen treatment to patients that have end stage liver disease 1. Between the years of 2008 and 2018, in Brazil, the number of cadaveric transplants has increased in 91.1% 2. In the American population, based on the United Network for Organ Sharing (UNOS), the survival of one year after the transplant can reach 89.7% 3, while in Brazil it reaches 75% 4. The greatest obstacle for healing of end stage liver disease patients is the shortage of organs number. In Brazil, until 2006, the base to allocating cadaveric livers was the time on waitlist, except for patients who had fulminant hepatitis or needed an emergency retransplatation. Using the score Model for End-Stage Liver Disease (MELD) we can estimate the severity of the cirrhotic patient and the mortality rate on waitlist, and recently this has been the base for the organ allocating system . The main goal of this presented study was to evaluate among the three scores which is more accurate and the better cut point for the brazilian population
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