Post-Transplant Liver Function Score as an Early Surrogate Marker of Long-Term Outcome

Background: Currently, there is no universally accepted method to evaluate liver function post-orthotopic liver transplant (OLTx) and there are no early surrogate function markers to assess the impact of perioperative interventions in trial settings. Material/Methods: We studied the performance of the Schindl scoring system and modified it to better predict post-orthotopic liver transplantation outcomes, using total bilirubin levels, international normalized ratio (INR), and lactic acid, resulting in a post-transplant liver function (PTLF) score. We retrospectively reviewed all adult liver transplants from deceased donors done between 1995 and 2012. Univariate and multivariate analyses were performed and Kaplan-Meier survival curves were obtained. Results: In total, 495 patients were included in the study. On multivariate analysis, PTLF score, defined as normal (score < 4) or dysfunctional (score 3 4), was the only significant variable for determining significant complications (P=0.014) and graft survival (P=002) during the perioperative period. Conclusions: PTLF score shows promise as an early surrogate marker of post-orthotopic liver transplantation mortality and morbidity by providing results within the first 7 days post-transplantation. PTLF score can potentially be used as a tool to assess the impact of perioperative interventions by predicting long-term outcomes early in the clinical course of transplant patients.