e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation
Objective:. This study aimed to analyze risk factors and develop a predictive model for early allograft loss due to early graft dysfunction (EGD) in adult live-donor liver transplantation (LDLT). Methods:. Data of patients who underwent LDLT from 2011 to 2019 were reviewed for EGD, associated factor...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2023-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000332 |
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| author | Viniyendra Pamecha, MS, MRCS, FRCS, FEBS Nilesh Sadashiv Patil, MS, MCh Tharun Gattu, MS Guresh Kumar, MSc, MPhil, PhD Bramhadatta Pattnaik, MS, MCh Nihar Mohapatra, MS, MCh Gaurav Sindwani, MD, PDCC Ashok Choudhury, MD, DM |
| author_facet | Viniyendra Pamecha, MS, MRCS, FRCS, FEBS Nilesh Sadashiv Patil, MS, MCh Tharun Gattu, MS Guresh Kumar, MSc, MPhil, PhD Bramhadatta Pattnaik, MS, MCh Nihar Mohapatra, MS, MCh Gaurav Sindwani, MD, PDCC Ashok Choudhury, MD, DM |
| author_sort | Viniyendra Pamecha, MS, MRCS, FRCS, FEBS |
| collection | DOAJ |
| description | Objective:. This study aimed to analyze risk factors and develop a predictive model for early allograft loss due to early graft dysfunction (EGD) in adult live-donor liver transplantation (LDLT).
Methods:. Data of patients who underwent LDLT from 2011 to 2019 were reviewed for EGD, associated factors, and outcomes. A homogeneous group of 387 patients was analyzed: random cohort A (n = 274) for primary analysis and random cohort B (n = 113) for validation.
Results:. Of 274 recipients, 92 (33.6%) developed EGD. The risk of graft loss within 90 days was 29.3% and 7.1% in those with and without EGD, respectively (P < 0.001). Multivariate logistic regression analysis determined donor age (P = 0.045), estimated (e) graft weight (P = 0.001), and the model for end-stage liver disease (MELD) score (0.001) as independent predictors of early graft loss due to EGD. Regression coefficients of these factors were employed to formulate the risk model: Predicted (P) early graft loss risk (e-GLR) score = 10 × [(donor age × 0.052) + (e-Graft weight × 1.681) + (MELD × 0.145)] − 8.606 (e-Graft weight = 0, if e-Graft weight ≥640 g and e-Graft weight = 1, and if e-Graft weight < 640 g). Internal cross-validation revealed a high predictive value (C-statistic = 0.858).
Conclusions:. Our novel risk score can efficiently predict early allograft loss following graft dysfunction, which enables donor-recipient matching, evaluation, and prognostication simply and reliably in adult LDLT. |
| format | Article |
| id | doaj-art-8abf650336cb4abf85cefa63493ba480 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-8abf650336cb4abf85cefa63493ba4802025-01-24T09:18:11ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932023-12-0144e33210.1097/AS9.0000000000000332202312000-00006e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver TransplantationViniyendra Pamecha, MS, MRCS, FRCS, FEBS0Nilesh Sadashiv Patil, MS, MCh1Tharun Gattu, MS2Guresh Kumar, MSc, MPhil, PhD3Bramhadatta Pattnaik, MS, MCh4Nihar Mohapatra, MS, MCh5Gaurav Sindwani, MD, PDCC6Ashok Choudhury, MD, DM7From the * Liver Transplant and Hepato-Pancreato-Biliary SurgeryFrom the * Liver Transplant and Hepato-Pancreato-Biliary SurgeryFrom the * Liver Transplant and Hepato-Pancreato-Biliary Surgery† BiostatisticsFrom the * Liver Transplant and Hepato-Pancreato-Biliary SurgeryFrom the * Liver Transplant and Hepato-Pancreato-Biliary Surgery‡ Anaesthesiology§ Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.Objective:. This study aimed to analyze risk factors and develop a predictive model for early allograft loss due to early graft dysfunction (EGD) in adult live-donor liver transplantation (LDLT). Methods:. Data of patients who underwent LDLT from 2011 to 2019 were reviewed for EGD, associated factors, and outcomes. A homogeneous group of 387 patients was analyzed: random cohort A (n = 274) for primary analysis and random cohort B (n = 113) for validation. Results:. Of 274 recipients, 92 (33.6%) developed EGD. The risk of graft loss within 90 days was 29.3% and 7.1% in those with and without EGD, respectively (P < 0.001). Multivariate logistic regression analysis determined donor age (P = 0.045), estimated (e) graft weight (P = 0.001), and the model for end-stage liver disease (MELD) score (0.001) as independent predictors of early graft loss due to EGD. Regression coefficients of these factors were employed to formulate the risk model: Predicted (P) early graft loss risk (e-GLR) score = 10 × [(donor age × 0.052) + (e-Graft weight × 1.681) + (MELD × 0.145)] − 8.606 (e-Graft weight = 0, if e-Graft weight ≥640 g and e-Graft weight = 1, and if e-Graft weight < 640 g). Internal cross-validation revealed a high predictive value (C-statistic = 0.858). Conclusions:. Our novel risk score can efficiently predict early allograft loss following graft dysfunction, which enables donor-recipient matching, evaluation, and prognostication simply and reliably in adult LDLT.http://journals.lww.com/10.1097/AS9.0000000000000332 |
| spellingShingle | Viniyendra Pamecha, MS, MRCS, FRCS, FEBS Nilesh Sadashiv Patil, MS, MCh Tharun Gattu, MS Guresh Kumar, MSc, MPhil, PhD Bramhadatta Pattnaik, MS, MCh Nihar Mohapatra, MS, MCh Gaurav Sindwani, MD, PDCC Ashok Choudhury, MD, DM e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation Annals of Surgery Open |
| title | e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation |
| title_full | e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation |
| title_fullStr | e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation |
| title_full_unstemmed | e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation |
| title_short | e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation |
| title_sort | e glr score predicts early graft loss in adult live donor liver transplantation |
| url | http://journals.lww.com/10.1097/AS9.0000000000000332 |
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