Pre-transplant ALBI Grade 3 Is Associated with Increased Mortality After Liver Transplantation

被引:20
作者
Bernardi, Nicole [1 ]
Chedid, Marcio F. [1 ]
Grezzana-Filho, Tomaz J. M. [1 ]
Chedid, Aljamir D. [1 ]
Pinto, Marcelo A. [1 ]
Leipnitz, Ian [1 ]
Prediger, Joao E. [1 ]
Prediger, Carolina [1 ]
Backes, Ariane N. [1 ]
Hammes, Thais O. [1 ]
Guerra, Lea T. [1 ]
de Araujo, Alexandre [2 ]
Alvares-da-Silva, Mario R. [2 ]
Kruel, Cleber R. P. [1 ]
机构
[1] Fed Univ Rio Grande do Sul UFRGS, Liver & Pancreas Transplant & Hepatobiliary Surg, Hosp Clin Porto Alegre, Rua Ramiro Barcelos 2350,6th Floor,Room 600, BR-90035903 Porto Alegre, RS, Brazil
[2] Fed Univ Rio Grande do Sul UFRGS, Hosp Clin Porto Alegre, Div Gastroenterol & Hepatol, Porto Alegre, RS, Brazil
关键词
ALBI; Prognostic factors; Mortality; Liver transplantation; ALBUMIN-BILIRUBIN GRADE; HEPATOCELLULAR-CARCINOMA; MELD SCORE; STAGE; SURVIVAL; MODEL; PREDICTOR; ALLOCATION; FAILURE; HCC;
D O I
10.1007/s10620-019-5456-6
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BackgroundAlthough MELD score is a reliable tool for estimating mortality in the waiting list, criteria for preoperative prediction of survival after liver transplantation (LT) are lacking. ALBI score was validated as a prognostic marker for hepatocellular carcinoma patients undergoing transarterial chemoembolization, hepatic resection, and sorafenib treatment but not for LT outcomes yet. This study aimed to evaluate ALBI score as a prognostic factor in LT.MethodsThisis a single-center analysis of patients undergoing LT between October 2001 and June 2017. Primary endpoint was overall post-LT mortality. Secondary endpoint was 90-day mortality.ResultsOf all 301 patients included in this study, 185 (61.5%) were males. Themedian age was 54.111.3years. Univariate and multivariate analysis revealed that ALBI grade 3 (HR 1.836, 95% CI 1.154-2.921, p=0.010), low serum albumin (HR 0.628, 95% CI 0.441-0.893, p=0.010), black race (HR 2.431, 95% CI 1.160-5.092, p=0.019), and elevated body mass index (HR 1.061, 95% CI 1.022-1.102, p=0.002) all were associated with decreased overall survival following LT. Patients with both ALBI grade 3 (n=25) and calculated MELD score25 had the lowest overall survival (p<0.001).Discussion p id=Par4 ALBI grade 3 was related to lower post-LT survival and can be utilized as a tool for risk stratification in LT.
引用
收藏
页码:1695 / 1704
页数:10
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