INTRODUCTION: The Sequential Organ Failure Assessment (SOFA) score has been applied for the prediction of survival in critically ill patients. We analysed the value of the SOFA score for the prediction of short-term survival after liver transplantation in high-risk liver transplant recipients with a labMELD score ≥30. PATIENTS AND METHODS: We conducted a retrospective single-centre analysis including 88 consecutive liver transplants in adults between January 1, 2007 and December 31, 2010 with a pre-transplant labMELD score ≥30. The SOFA score was assessed preoperatively, directly after transplantation and on post-operative days (PODs) 1-10. Combined and living-related liver transplants were excluded. Receiver operating characteristic (ROC) curve analysis with the Hosmer-Lemeshow test and application of the Brier score were used to calculate sensitivity, specificity, overall model correctness and calibration. Cutoff values were selected with the best Youden index. RESULTS: ROC curve analysis showed areas under the curve (AUROCs) >0.8 for the SOFA score on PODs 1-10 for the prediction of hospital mortality, 30-day mortality and 3-month mortality with Hosmer-Lemeshow test results that confirmed good model calibration (p > 0.05). The Brier score demonstrated an accuracy of prediction (<0.25) of hospital mortality, 30-day mortality and 3-month mortality for the SOFA scores on PODs 4-9 indicating superior accuracy on PODs 7 and 8 with cutoff values for the SOFA score between 16.5 and 18.5. The pre-transplant SOFA score failed to reach AUROCs >0.7 (0.603-0.663) for the prediction of short-term survival. CONCLUSIONS: Our results confirm the usefulness of the SOFA score in high-risk liver recipients during the early post-operative course, especially on PODs 7-8 for the prediction of hospital mortality, 30-day mortality and 3-month mortality and may be useful to predict futile early acute retransplantation.
INTRODUCTION: The Sequential Organ Failure Assessment (SOFA) score has been applied for the prediction of survival in critically ill patients. We analysed the value of the SOFA score for the prediction of short-term survival after liver transplantation in high-risk liver transplant recipients with a labMELD score ≥30. PATIENTS AND METHODS: We conducted a retrospective single-centre analysis including 88 consecutive liver transplants in adults between January 1, 2007 and December 31, 2010 with a pre-transplant labMELD score ≥30. The SOFA score was assessed preoperatively, directly after transplantation and on post-operative days (PODs) 1-10. Combined and living-related liver transplants were excluded. Receiver operating characteristic (ROC) curve analysis with the Hosmer-Lemeshow test and application of the Brier score were used to calculate sensitivity, specificity, overall model correctness and calibration. Cutoff values were selected with the best Youden index. RESULTS: ROC curve analysis showed areas under the curve (AUROCs) >0.8 for the SOFA score on PODs 1-10 for the prediction of hospital mortality, 30-day mortality and 3-month mortality with Hosmer-Lemeshow test results that confirmed good model calibration (p > 0.05). The Brier score demonstrated an accuracy of prediction (<0.25) of hospital mortality, 30-day mortality and 3-month mortality for the SOFA scores on PODs 4-9 indicating superior accuracy on PODs 7 and 8 with cutoff values for the SOFA score between 16.5 and 18.5. The pre-transplant SOFA score failed to reach AUROCs >0.7 (0.603-0.663) for the prediction of short-term survival. CONCLUSIONS: Our results confirm the usefulness of the SOFA score in high-risk liver recipients during the early post-operative course, especially on PODs 7-8 for the prediction of hospital mortality, 30-day mortality and 3-month mortality and may be useful to predict futile early acute retransplantation.
Authors: Evangelos Cholongitas; Alex Betrosian; Marco Senzolo; Steve Shaw; David Patch; Pinelopi Manousou; James O'Beirne; Andrew K Burroughs Journal: J Gastroenterol Hepatol Date: 2007-12-13 Impact factor: 4.029
Authors: Daliana Peres Bota; Christian Melot; Flavio Lopes Ferreira; Vinh Nguyen Ba; Jean-Louis Vincent Journal: Intensive Care Med Date: 2002-09-06 Impact factor: 17.440
Authors: Tobias J Weismüller; Panagiotis Fikatas; Jan Schmidt; Ana P Barreiros; Gerd Otto; Susanne Beckebaum; Andreas Paul; Markus N Scherer; Hartmut H Schmidt; Hans J Schlitt; Peter Neuhaus; Jürgen Klempnauer; Johann Pratschke; Michael P Manns; Christian P Strassburg Journal: Transpl Int Date: 2010-09-03 Impact factor: 3.782
Authors: R Moreno; J L Vincent; R Matos; A Mendonça; F Cantraine; L Thijs; J Takala; C Sprung; M Antonelli; H Bruining; S Willatts Journal: Intensive Care Med Date: 1999-07 Impact factor: 17.440
Authors: Mathew Jacob; Lynn P Copley; James D Lewsey; Alex Gimson; Giles J Toogood; Mohamed Rela; Jan H P van der Meulen Journal: Liver Transpl Date: 2004-07 Impact factor: 5.799
Authors: Nicholas N Onaca; Marlon F Levy; Edmund Q Sanchez; Srinath Chinnakotla; Carlos G Fasola; Mark J Thomas; Jeffrey S Weinstein; Natalie G Murray; Robert M Goldstein; Goran B Klintmalm Journal: Liver Transpl Date: 2003-02 Impact factor: 5.799
Authors: Benedikt Reichert; Alexander Kaltenborn; Thomas Becker; Mario Schiffer; Jürgen Klempnauer; Harald Schrem Journal: Langenbecks Arch Surg Date: 2014-03-30 Impact factor: 3.445
Authors: Harald Schrem; Anna-Luise Platsakis; Alexander Kaltenborn; Armin Koch; Courtney Metz; Marc Barthold; Christian Krauth; Volker Amelung; Felix Braun; Thomas Becker; Jürgen Klempnauer; Benedikt Reichert Journal: Langenbecks Arch Surg Date: 2014-09-14 Impact factor: 3.445
Authors: Lisa Rausch; Christian Koenecke; Hans-Friedrich Koch; Alexander Kaltenborn; Nikos Emmanouilidis; Lars Pape; Frank Lehner; Viktor Arelin; Ulrich Baumann; Harald Schrem Journal: Transplant Res Date: 2016-08-02