A novel prognostic model based on serum levels of total bilirubin and creatinine early after liver transplantation

Background/ aim: We aim to evaluate the impact of early renal dysfunction ( ERD), early allograft dysfunction ( EAD) on post- transplant mortality, and further explore a simple and accurate model to predict prognosis. Patients: A total of 161 adult patients who underwent liver transplantation for benign end- stage liver diseases were enrolled in the retrospective study. Another 38 patients were used for model validation. Results: Poor patient survival was associated with ERD or EAD. A post- transplant model for predicting mortality ( PMPM) based on serum levels of total bilirubin and creatinine at 24- h post- transplantation was then established according to multivariate logistic regression. At 3 months, 6 months and 1 year, the area under receiver operating characteristic curves ( AUC) of PMPM score at 24- h post- transplantation ( 0.876, 0.878 and 0.849, respectively) were significantly higher than those of pre- transplant model for end- stage liver diseases ( MELD) score ( 0.673, 0.674 and 0.618, respectively) or the post- transplant MELD score at 24- h post- transplantation ( 0.787, 0.787 and 0.781, respectively) ( P < 0.05). Patients with PMPM score <= - 1.4 ( low- risk group, n = 114) achieved better survival than those with PMPM score > - 1.4 ( high- risk group, n = 47) ( P < 0.001). The patients in the high- risk group showed a relatively good outcome if their PMPM scores decreased to <= - 1.4 at post- transplant day 7. The subsequent validation study showed that PMPM functioned with a predictive accuracy of 100%. Conclusion: The PMPM score could effectively predict shortand medium- term mortality in liver transplant recipients.