Journal: | Annals of hepatology |
Database: | PERIÓDICA |
System number: | 000411752 |
ISSN: | 1665-2681 |
Authors: | Cardoso, Filipe S1 Bagshaw, Sean M1 Abraldes, Juan G1 Kneteman, Norman M1 Meeberg, Glenda2 Fidalgo, Pedro1 Karvellas, Constantine J1 |
Institutions: | 1University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta. Canadá 2Alberta Health Services, Liver Transplant Program, Edmonton, Alberta. Canadá |
Year: | 2015 |
Season: | Jul-Ago |
Volumen: | 14 |
Number: | 4 |
Pages: | 505-514 |
Country: | México |
Language: | Inglés |
Document type: | Artículo |
Approach: | Analítico, descriptivo |
English abstract | Improving estimation of long-term survival of patients with end-stage liver disease after orthotopic liver transplantation (OLT) would optimize decisions on eligibility for transplant. We aimed to externally validate previously derived Charlson Comorbity Index for OLT (CCI-OLT); subsequently, we developed a new model to predict 5-year mortality after transplant. Material and methods. This single center retrospective cohort study included 524 consecutive adult cirrhotic patients who underwent OLT in 2002-2012. External validation of CCI-OLT used Kaplan-Meier method. Derivation of the new predictive model used Cox proportional hazards regression. Results. One-, 3-, and 5-year cumulative survival after OLT was 89%, 80%, and 73%, respectively. CCI-OLT was not associated with 5-year mortality after transplant (P = 0.34). We derived and internally validated a new predictive model of 5-year mortality after OLT based on six pre-transplant characteristics of patients: age, body mass index, hepatitis C, hepatic encephalopathy, intensive care unit stay at transplant, and live donor (C-index = 0.64). We further developed a nomogram to estimate individual probability of 1-, 3-, and 5-year survival after OLT. Conclusions. In our cohort, CCI-OLT was not associated with survival following transplant. The new predictive model discriminative capacity was only modest, suggesting that pre-transplant characteristics are of limited value in predicting post-transplant outcomes in thoroughly selected patients |
Disciplines: | Medicina |
Keyword: | Cirugía, Gastroenterología, Cirrosis, Trasplante de hígado, Nomograma, Sobrevida, Comorbilidad |
Keyword: | Medicine, Gastroenterology, Surgery, Cirrhosis, Liver transplantation, Nomogram, Survival, Comorbidity |
Full text: | Texto completo (Ver PDF) |