Individual Risk Management Research Articles

Towards patient engagement in violence risk assessment and management: a patient perspective

IntroductionIn current clinical practices, there exist very few methods that allow patients to be truly engaged in violence risk assessment and management. This may hinder an individual’s experience of basic psychological needs; autonomy, competence, and relatedness.ObjectivesTo describe patients’ ideas on how they would develop current violence risk assessment and management practices.MethodsThe data collection took place as part of a larger project in one PICU unit specialized in the treatment of patients with psychosis and violent behavior in Finland. Individual interviews were conducted with patients (n=13) and were guided to focus on the development of violence risk assessment and management. The data were analyzed using inductive content analysis.ResultsPatients’ ideas focused on themes related to developing patient engagement and violence risk management methods. Developing patient engagement involved noticing patient’s individuality and collaboration between a patient and staff: for instance, by shared risk assessment and individualized risk management. Developing violence risk management methods included themes about providing alternative risk management methods and developing nursing staff’s work. Suggestions were, for example, related to providing ways how to calm down, having meaningful activities during treatment days, and ensuring the realization of patient’s rights.ConclusionsPatients having treatment in the PICU unit have clear and concrete ideas on how violence risk assessment and management methods could be developed further. These findings indicate, that patients need to be given a more active role in their care and thus ensure that basic psychological needs are promoted. Funding by Academy of Finland (316206 ) and TYKS foundation.DisclosureNo significant relationships.

A field study of acute dynamic risk assessment in individuals convicted of sexual offenses.

Acute dynamic risk factors can change over short periods of time, even within days or hours. When making risk assessments of individuals convicted of sexual offenses, it is necessary to consider this rapidity of change, in order to monitor appropriately the recidivism risk and to prevent future crimes. Until now, there is only one instrument-the Acute-2007-which assesses acute risk factors in individuals convicted of sexual offenses. However, the current state of research about its psychometric properties is still limited. The aim of the present study was to examine the German version of the Acute-2007 in a final sample of N = 534 adult male individuals convicted of a sexual offense in Germany. Within a prospective-longitudinal field study, appropriately trained parole officers used the Acute-2007 directly after a case was allocated to them. By using an average follow-up period of M = 3.83 years, recidivism data were drawn from the Federal Central Criminal Register of the Federal Office of Justice. Results revealed that the Acute-2007 predicted moderately general (AUC = .64), sexual (AUC = .64), and violent (AUC = .64) recidivism. By using Cox regression analysis, the Acute-2007 significantly predicted the time periods until a sexual reoffense. Furthermore, the Acute-2007 added incremental predictive validity beyond the Static-99 in the prediction of sexual recidivism. Taken together, the results of the present study support the relevance of acute dynamic risk factors in risk assessment and management of individuals convicted of sexual offenses. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Report from an NCI Roundtable: Cancer Prevention in Primary Care.

The Division of Cancer Prevention in the NCI sponsored a Roundtable with primary care providers (PCP) to determine barriers for integrating cancer prevention within primary care and discuss potential opportunities to overcome these barriers. The goals were to: (i) assess the cancer risk assessment tools available to PCPs; (ii) gather information on use of cancer prevention resources; and (iii) understand the needs of PCPs to facilitate the implementation of cancer prevention interventions beyond routine screening and interventions. The Roundtable discussion focused on challenges and potential research opportunities related to: (i) cancer risk assessment and management of high-risk individuals; (ii) cancer prevention interventions for risk reduction; (iii) electronic health records/electronic medical records; and (iv) patient engagement and information dissemination. Time constraints and inconsistent/evolving clinical guidelines are major barriers to effective implementation of cancer prevention within primary care. Social determinants of health are important factors that influence patients' adoption of recommended preventive interventions. Research is needed to determine the best means for implementation of cancer prevention across various communities and clinical settings. Additional studies are needed to develop tools that can help providers collect clinical data that can enable them to assess patients' cancer risk and implement appropriate preventive interventions.

Assessing Breast Cancer Risks to Improve Care for an Increased-Risk Population within Eastern North Carolina.

BACKGROUND The average lifetime risk of breast cancer for an American woman is 12.5%, but individual risks vary significantly. Risk modeling is a standard of care for breast cancer screening and prevention with recommended tools to stratify individual risks based on age, family history, breast density, and a host of other known risk factors. Because of a lack of resources rurally, we have not consistently met this standard of care within all of North Carolina.METHODS We implemented a quality improvement project to assess the risk for breast cancer by gathering data on community risks. We implemented an evidence-based tool (Tyrer-Cuzick) for quantifying risk within a mostly rural population of Eastern North Carolina and developed customized services for women meeting elevated-risk definition. These services included additional imaging for elevated-risk women and a risk-reduction program. We also assessed genetic risks for hereditary breast and ovarian cancer in our at-risk population using National Comprehensive Cancer Network (NCCN) guidelines based on family history and added local genetics extenders to help test more women. We analyzed data regularly using Plan-Do-Study-Act methods to improve outcomes over 1 year.RESULTS We screened a population of 4500 women at a community hospital over a 1-year period for their individual lifetime cancer risk and genetic risk. Breast cancer risk was quantitated at the time of mammography, and women were stratified into 3 groups for risk management. Within our screening population, 6.3% of women were at high risk (defined by a lifetime breast cancer risk greater than or equal to 20%) and another 8.1% were above-average risk (defined by a lifetime breast cancer risk of 15%-20%). These women (14.4%) could potentially benefit from additional risk-management strategies. Additionally, 20% of all unaffected women within a typical screening population of Eastern North Carolina met NCCN guidelines for hereditary breast cancer and ovarian cancer testing independent of their cancer risk score. Using a model of targeted intervention within a population with elevated risks can be helpful in improving outcomes.LIMITATIONS This population within Eastern North Carolina is mostly rural and represents a potentially biased population, as it involves older women undergoing annual mammography. It may not be broadly applicable to the entire population based on age, geography, and other risks.CONCLUSIONS This model for improving cancer risk assessment and testing at a small community hospital in Eastern North Carolina was successful and addressed a community need. We discovered a high rate of increased-risk women who can benefit from individualized risk management, and a higher percentage of women who potentially benefit from genetic testing. These higher cumulative risks may in part explain some of the disparities seen for breast-cancer-specific outcomes in some parts of the state.

Development of a tool for individual aquatic risk management among children

Background: When it comes to children’s competence in, on and around water, their risk competence also plays an important role. For an optimal and save participation in aquatic recreation, there is a crucial need to communicate about a realistic perception of potential dangers in relation to one’s own acutal and perceived aquatic skills. 
 Goals: The aim of this study was to develop and validate a tool for Individual Aquatic Risk Management for Children (IARM-C) useful in both research and practice regarding water safety for elementary school children and their families, as offered in schools, by local communities and different (water) sport organisations.
 Method:
 The IARM-C tool was developed and validated in three subsequent phases: (1) a selection of relevant aquatic situations with possible risks for children based on the literature and discussed with experts, resulting in 10 aquatic situations that were drawn, (2) a pilot study with 22 children to test content (face) validity, and (3) a cross-sectional study with 70 children (6-12 years, 35 girls and 35 boys, 8.9 +/- 2.0 yearsrecruited via convenience sampling in different (swimming) schools in Brussel (Belgium) to test their risk perception, assessement and decision making in these 10 situations.
 Results:
 For each of the 10 aquatic risk situations of the IARM-C, data collection was organised in a one-on-one interview in order to assist the child in completing the questionnaire. Six of the 10 pictures resulted in a correct risk perception for > 80% (range between 83-94%) of the children. For one drawn aquatic risk situation in the swimming pool context (i.e. falling on someone else), only 60% of the children gave a correct description of the situation. In the drawn open water aquatic risk situations, three pictures scored quite low (about 50% (range between 49%-54%)): warning flag at sea, dangerous objects in open water and sandbank at the sea.
 Conclusions:
 The IARM-C tool, showing pictures of aquatic risk situations followed by three categories of questions (risk perception, assessement and decision making), is a usefull instrument for further research and education purposes, especially the swimming pool cases (> 80%).

Individual Investors' Stock Investment Risk Management Measures

Individual Investors' Stock Investment Risk Management Measures

Competitiveness of the Regions in the Czech Republic from the Perspective of Disaster Risk Financing

Mitigation of the impact of disasters and increasing resilience represent an inseparable part of the competitiveness of regions that cannot be implemented without a necessary resource framework. The paper focuses on the issue of financing individual phases of disaster management at the level of regions in the Czech conditions. The article is based on the assumption that public authorities do not systematically plan funds for dealing with crisis situations in the expenditure part of the budget, thereby not supporting the structural and functional conditions of territorial attractiveness, security and sustainability. The aim of the article is to propose a unique calculation of the minimum fund allocation for individual phases of disaster risk reduction at the regional level. The calculation concept is based on the value of the property owned by the region, the number of crisis situations predicted in the region, the number of crisis situations predicted in the Czech Republic, the administrative territory of the region and the total expenditures of the regional budget. The article presents a specific national approach to the public fund allocation to the individual disaster risk management phases, providing competitive administration and progressive and resilient development of the region. Based on the originally elaborated calculation, a comparative analysis of the expenditure part of 13 regional budgets for the 2013– 2019 period was performed. The premise on the insufficient financing of disaster management was confirmed, although the Crisis Management Act imposes this obligation. The results showed that the most underfunded area was the implementation phase.

The Science Behind Multidomain Interventions to Slow Cognitive Decline

The spotlight on interventions to protect brain health and prevent Alzheimer’s disease (AD) has recently widened to include risk modification. In the last 20 years, evidence continues to build to support cognition-enhancing effects of individual lifestyle components, which include, among others, physical exercise, diet, cognitive training, and cardiovascular risk management. A recent evolution of lifestyle trials is to combine these components as part of intervention delivery. The potential benefit of this approach on cognition in older adults, first showcased in the FINGER trial, is now under investigation by multiple groups across the nation and the globe. The multidomain approach offers important opportunities to boost lifestyle intervention ‘dose’, to examine inter-component synergistic effects, and for intervention tailoring to meet specific needs and limitations. Harmonization and data-sharing will be essential to meaningfully address the question of whether multidomain lifestyle modification can indeed be ‘medicine’ to protect brain health and reduce AD risk.

Healthy eating - a modifiable contributor to optimize healthy living in the COVID-19 pandemic: a review.

The outbreak of the novel severe acute respiratory syndrome coronavirus 2 infection in 2019 has posed major risks to global health and the economy. This coronavirus disease (COVID‐19) pandemic has changed many of our everyday habits, including how we function and socialize, how we eat, and food preferences and selection. The average intake and status of certain vitamins and minerals can result in reduced immunity, which makes people more susceptible to illnesses and exacerbates malnutrition. The most critical factors in this scenario are individual risk evaluation and management techniques. Until general therapies are administered, the nutritional status of each infected patient should be assessed. The differing clinical severity of COVID‐19 – from asymptomatic, to mild, to severe, to death – depends on the different metabolic status of the hosts who have contracted the virus, which is determined by their diet, age, gender, health, lifestyle, and environmental factors. A broad systematic exploration on studies of this disease was steered by means of electronic databases and was limited to articles published in English (or with an English abstract) in publications using words like ‘health’, ‘diet’, ‘food’, ‘nutritional status’, ‘COVID‐19’, ‘pandemic’, ‘modifiable contributor’, ‘immune system’, ‘micronutrients’, ‘vitamin’, and so on. Careful individual consideration of the potential dietary, nutritional, medical, lifestyle, and environmental hazards, along with any supplementation with micronutrients wherever required to help to boost the body's natural defence system, with the intention to improve all levels of immunity and the use of effective risk management techniques are appropriate ways to handle the COVID‐19 pandemic. © 2021 Society of Chemical Industry.

Are the Competency-Based Risk Management Certificate Holders Ready for Change? A Descriptive Study of Readiness for Change

Organizations need to make effective changes to address VUCA conditions to survive and be sustainable. The readiness of members of the organization to make changes plays an essential role in ensuring the effectiveness of organizational's change. As a member of an organization, the risk management certificate holder is expected to be capable of ability and psychologically ready for organizational changes in implementing risk management. This study aims to provide empirical evidence regarding the readiness of competency-based risk management certificate holders to make changes, especially to implement more mature risk management in organizations. This study used a quantitative descriptive approach with a survey method. The survey was conducted online using a self-administered questionnaire modified and adapted from the Organizational Readiness for Implementing Change measurement tool. The sample in this study focused on individuals who have a general competency-based risk management certificate—the sampling technique conducted by convenience sampling technique.
 Regarding data analysis, the researcher used descriptive statistical analysis. This study indicates that 54.5% of competency-based risk management certificate holders have a high level of readiness compared to individuals in their group. It shows that risk management certificate holders have high readiness to make changes to implement risk management in their organization. The findings of the two dimensions also form the variable, namely, change commitment and change efficacy. The results show that the competency-based risk management certificate holders' change commitment impacts their readiness to make changes than their change efficacy. It indicates that the certificate holders have a higher share resolved to pursue the action than their shared belief in the collective capabilities to organize and execute the change in the organizations. From the findings of this study, organizations can develop strategies to further increase the confidence of their shared capabilities in organizations, especially for individual risk management certificate holders, so that the effectiveness of changes made by the organization in implementing risk management will be higher.

Differences in Ovarian and Other Cancers Risks by Population and BRCA Mutation Location.

Hereditary breast and ovarian cancer is caused by a germline mutation in BRCA1 or BRCA2 genes. The frequency of germline BRCA1/2 gene mutation carriers and the ratio of germline BRCA1 to BRCA2 mutations in BRCA-related cancer patients vary depending on the population. Genotype and phenotype correlations have been reported in BRCA mutant families, however, the correlations are rarely used for individual risk assessment and management. BRCA genetic testing has become a companion diagnostic for PARP inhibitors, and the number of families with germline BRCA mutation identified is growing rapidly. Therefore, it is expected that analysis of the risk of developing cancer will be possible in a large number of BRCA mutant carriers, and there is a possibility that personal and precision medicine for the carriers with specific common founder mutations will be realized. In this review, we investigated the association of ovarian cancer risk and BRCA mutation location, and differences of other BRCA-related cancer risks by BRCA1/2 mutation, and furthermore, we discussed the difference in the prevalence of germline BRCA mutation in ovarian cancer patients. As a result, although there are various discussions, there appear to be differences in ovarian cancer risk by population and BRCA mutation location. If it becomes possible to estimate the risk of developing BRCA-related cancer for each BRCA mutation type, the age at risk-reducing salpingo-oophorectomy can be determined individually. The decision would bring great benefits to young women with germline BRCA mutations.

A strengths model and violence risk assessment with individuals not criminally responsible on account of mental disorder (NCRMD) in Canada

ABSTRACT A Strengths Model of violence risk assessment, integrating a strengths-based psychosocial history in mental health recovery and protective factors of violent risk reduction, is proposed to address the concern about overprediction of violence in assessment with forensic mental health patients based on risk factors of violence. A case illustration is presented to demonstrate the Model’s capability to promote a more balanced violence risk assessment and formulate individualized risk management and recovery plan predicated on the person’s strengths and resources. Implications for clinical practice and the potential in research to enhance predictive validity and accuracy in violence risk assessment are discussed.

Individual risk management strategy for SARS-CoV-2 infection: A step toward personalized healthcare

Lethal or critical COVID-19 occurs most in infected hosts with certain risk factors such as advanced age or pre-existing disease. Host metabolic status significantly affects the clinical presentations of SARS-CoV-2 infection. Individual risk management is thus crucial for preventing severe COVID-19. Such susceptibility is individual, depending on a multitude of factors. Personalized risk assessment requires the inclusive analysis of big health data to stratify individual risk and derive a customized action plan. Personalized medicine requires shifting from the virology aspect per se to the whole individual's consideration, including dietary pattern, nutritional status, supporting lifestyle, co-existing diseases, and environmental factors. In this short communication, we discuss the individual management strategy for SARS-CoV2 infection as a step towards future personalized healthcare.

An integrated clinical and genetic model for predicting risk of severe COVID-19: A population-based case-control study.

Up to 30% of people who test positive to SARS-CoV-2 will develop severe COVID-19 and require hospitalisation. Age, gender, and comorbidities are known to be risk factors for severe COVID-19 but are generally considered independently without accurate knowledge of the magnitude of their effect on risk, potentially resulting in incorrect risk estimation. There is an urgent need for accurate prediction of the risk of severe COVID-19 for use in workplaces and healthcare settings, and for individual risk management. Clinical risk factors and a panel of 64 single-nucleotide polymorphisms were identified from published data. We used logistic regression to develop a model for severe COVID-19 in 1,582 UK Biobank participants aged 50 years and over who tested positive for the SARS-CoV-2 virus: 1,018 with severe disease and 564 without severe disease. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC). A model incorporating the SNP score and clinical risk factors (AUC = 0.786; 95% confidence interval = 0.763 to 0.808) had 111% better discrimination of disease severity than a model with just age and gender (AUC = 0.635; 95% confidence interval = 0.607 to 0.662). The effects of age and gender are attenuated by the other risk factors, suggesting that it is those risk factors-not age and gender-that confer risk of severe disease. In the whole UK Biobank, most are at low or only slightly elevated risk, but one-third are at two-fold or more increased risk. We have developed a model that enables accurate prediction of severe COVID-19. Continuing to rely on age and gender alone (or only clinical factors) to determine risk of severe COVID-19 will unnecessarily classify healthy older people as being at high risk and will fail to accurately quantify the increased risk for younger people with comorbidities.

Financial well-being of Retirees Community in Nigeria

PurposeThe purpose of this paper is to investigate the financial well-being of often-neglected group in the society. The authors examined the role of risk management and social capital in the financial well-being of the retirees in Nigeria.Design/methodology/approachA quantitative method of research is used with a six-point Likert scale questionnaire. A survey was conducted to 376 retirees from public organizations to determine the perception of their financial well-being in post-retirement era. The sample population is selected using the simple random sampling technique. An exploratory factor analysis, confirmatory factor analysis and structural equation modeling are used to analyze the data.FindingsThe results indicate that both risk management and social capital are significant predictors of retirees’ financial well-being in the Nigeria context. All respondents have a good education background.Research limitations/implicationsThis study focused on retirees who have worked in public organizations in Nigeria. Thus, it is likely that the results may not be generalized to other settings. The results show that to promote financial well-being among retirees, the focus should be put mainly on individual risk management and maintaining good social capital.Originality/valueThe present study is first of its kind that focuses on contributory role of risk management and social capital in influencing the financial well-being of retirees in Nigeria. Findings make a novel contribution to retirees’ financial well-being literature by clarifying the significant role played by risk management and social capital in promoting the financial well-being of retirees in a developing country, specifically in Nigeria.

РОЗРОБЛЕННЯ СИСТЕМИ ЗАБЕЗПЕЧЕННЯ ЕКОНОМІЧНОЇ БЕЗПЕКИ ПІДПРИЄМСТВА В УМОВАХ МІНЛИВОГО СЕРЕДОВИЩА

The article provides theoretical and practical recommendations for improving the state of economic security in the enterprise in a changing environment.The origin of the concept of "enterpriseeconomic security" was studied and information on the basic concepts of economic security was provided.The main problems of ensuring the desired level of economic security at domestic enterprises were also considered, the use of clear methods for developing an effective system of economic security was proposed and the structure and stages of monitoring the state of economic security of the enterprise as a whole were given.The proposed monitoring system allows focusing on such phenomena and processes as the selection of the most important elements of the economic security of the enterprise and determining the composition, structure, methods of assessing the effectiveness of the organization's internal control system, risk management methods and methods of eliminating threats to safe operating of business entity. Information was also provided on how to implement an effective mechanism for the operation of the internal cost control service for business entity to improve its overall security. Recommendations were provided for small, medium-sized and large enterprises on the feasibility of creating a separate unit of economic security and recommendations for the formation of an individual risk and threat management system for each business entity. The paper proved that economic security is a complex indicator that is affected by many risks and threats of the enterpriseexternal and internal environment. Sources of these risks may include sources of negative impact, which are related to the financial situation in the market, technological innovations and scientific discoveries, force majeure, etc. In order to comprehensively monitor and control the activities of the enterprise it is necessary to develop a system of indicators of economic security for certain components, which determines the direction of further research in this area.

Risk factors for dental caries in Latin American and Caribbean countries.

Identifying the risk factors for dental caries is vital in epidemiology and clinical practices for developing effective preventive strategies, both, at the individual and collective levels. Different causality/determination models have been proposed to understand the development process of dental caries. In the present review, we designed a model inspired by the world-known social determinants models proposed in the 90s and more recently in the 10s, wherein the contextual factors are placed more externally and encompass the individual factors. The contextual factors included those related to the cultural and societal values, as well as the social and health government policies. The individual factors were classified into the following categories: socioeconomic (social class, occupation, income, and education level), demographic characteristics (age, sex, and ethnicity), behavioral factors (non-use of fluoride dentifrice, sugar consumption, poor oral hygiene, and lack of preventive dental care), and biological factors (recent caries experience/active caries lesions, biofilm retentive factors, developmental defects of the enamel, disabilities, saliva amount and quality, cariogenic biofilm). Each of these variables was addressed, while focusing on the current evidence from studies conducted in Latin American and Caribbean countries (LACC). Based on the proposed model, educational aspects were addressed, and individual caries risk assessment and management decisions were proposed; further, implications for public health policies and clinical practice were described. The identification of modifiable risk factors for dental caries should be the basis for multi-strategy actions that consider the diversity of Latin American communities.

The Ways of Implementation of the Optimization Principle in the Personnel Radiological Protection

An overview of the joint works undertaken by the specialists of Ural Federal University, the Institute of Mathematics and Mechanics of the Russian Academy of Sciences, and the Institute of Reactor Materials (IRM) in certain areas of implementing the optimization principle in radiological protection of nuclear industry personnel is provided. The effectiveness and the capacity of using routing optimization when carrying out works in unsteady radiation fields (when relocating and dismantling equipment of radioactive systems) are evaluated. The results of works on designing the composition of homogeneous radiation-protective materials (RPM) and their capacity to implement the optimization principle in the planning of radiation-hazardous works, including by the example of AO IRM and in ion-selective treatment of liquid radioactive waste, are analyzed. The application of the optimization principle for individual personnel radiation risk management at AO IRM is discussed.

Sector response plan for comprehensive health risk management for air quality in Bogotá, as a public health policy

Background: In Bogotá, 2,165 deaths from cardiovascular and respiratory diseases are attributed annually to air pollution. The impact on health due to air pollution in the Capital District, especially by PM10 is evident for the years 2015-2018. The proportion of children who presented wheezing in the last year was 74.3%, with a difference between greater and lesser exposure of 79.6% vs. 69.0% (p < 0.05). Symptoms of wheezing and expectoration were associated with higher PM10 exposure (RR 1.39 and 1.30). A child under 5 years of age exposed to PM10 is 1.70 times more at risk of being absent from school due to acute respiratory disease, and a decrease in PM10 would reduce this absence by 41.1%. The response from the health sector continues to be fragmented and reactive in the face of contingency levels of the environmental authorityObjective: Design in a participatory way a strategic plan of response of the health sector for the improvement of air quality.Results:1.Health Promotion-Air Governance: It is the participation of citizens in air management in Bogotá-Region.2.Collective Risk Management: Social communication of risk in both contingencies and pre-contingencies from the IBOCA: Bogota Air Quality Index.3. Individual Risk Management: It is the counseling or orientation that is done in the outpatient consultation to the general population and in patients with basic diseases on air quality and health. It also includes the assessment of population vulnerability to air pollution from the life course and the socioeconomic condition of individuals, families and communities.4.Public Health Management: Inclusion of estimates of exposure to air pollution through averages closest to the population: nowcast.Conclusions: Through a knowledge translation methodology and with institutional and citizen participation, the preparation of a proposal for a Strategic Plan for the Health Sector against Air Pollution was achieved.

HLA class II donor specific antibodies are associated with graft cirrhosis after liver transplant independent of the mean fluorescence intensity level

BackgroundThe importance of donor-specific antibodies (DSA) after liver transplantation (LT) for graft and patient survival is an ongoing controversy. So far it has not been elucidated when and in how far DSA are harmful for graft and patient survival. Therefore, we had the aim to investigate the association of DSA with complications after LT.MethodsData of 430 LT recipients were collected and statistically analyzed. Detection of HLA antibodies (Ab) was performed by Luminex assay.ResultsDSA were detected in 81 patients (18.8%). These were mainly HLA class II Ab (81.5%). HLA class II Ab show a higher MFI (median: 5.300) compared to HLA class I Ab (median: 2.300). There is no association between MFI levels and development of complications after LT. However, cirrhosis occurred significantly more often in DSA positive patients (18%) than in patients without detectable DSA (9%, P = 0.027). All DSA positive patients with cirrhosis of the graft showed HLA class II antibodies (OR: 3.028; 95% CI: 1.51–6.075; P = 0.002).ConclusionOccurrence of HLA class II DSA after LT is associated with graft cirrhosis and may indicate a higher risk to develop graft damage independent on MFI and requires an individualized risk management.