Application of the BAR score as a predictor of short- and long-term survival in liver transplantation patients

The balance of risk (BAR) is a prediction system after liver transplantation. To assess the BAR system, a retrospective observational study was performed in 402 patients who had transplant surgery between 1997 and 2012. The BAR score was computed for each patient. Receiver operating characteristic curve analysis with the Hosmer-Lemeshow test was used to calculate sensitivity, specificity, and model calibration. The cutoff value with the best Youden index was selected. Statistical analysis employed the Kaplan-Meier method (log-rank test) for survival, the Mann-Whitney test for group comparison, and multiple logistic regression analysis. 3-month survival was 46 % for BAR a parts per thousand yen11 and 77 % for BAR < 11 (p = 0.001); 12-month survival was 44 % for BAR a parts per thousand yen11 and 69 % for BAR < 11 (p = 0.001). Factors of survival < 3 months were BAR a parts per thousand yen11 [odds ratio (OR) 3.08; 95 % confidence interval (CI) 1.75-5.42; p = 0.001] and intrasurgical use of packed red blood cells (RBC) above 6 units (OR 4.49; 95 % CI 2.73-7.39; p = 0.001). For survival < 12 months, factors were BAR a parts per thousand yen11 (OR 2.94; 95 % CI 1.67-5.16; p = 0.001) and RBC > 6 units (OR 2.99; 95 % CI 1.92-4.64; p = 0.001). Our study contributes to the incorporation of the BAR system into Brazilian transplantation centers.