Several studies have explored the risk of graft dysfunction after liver transplantation (LT) in recent years. Conversely, risk factors for graft discard before or at procurement have poorly been investigated. The study aimed at identifying a score to predict the risk of liver-related graft discard before transplantation. Secondary aims were to test the score for prediction of biopsy-related negative features and post-LT early graft loss. A total of 4207 donors evaluated during the period January 2004–Decemeber 2018 were retrospectively analyzed. The group was split into a training set (n = 3,156; 75.0%) and a validation set (n = 1,051; 25.0%). The Donor Rejected Organ Pre-transplantation (DROP) Score was proposed: − 2.68 + (2.14 if Regional Share) + (0.03*age) + (0.04*weight)-(0.03*height) + (0.29 if diabetes) + (1.65 if anti-HCV-positive) + (0.27 if HBV core) − (0.69 if hypotension) + (0.09*creatinine) + (0.38*log10AST) + (0.34*log10ALT) + (0.06*total bilirubin). At validation, the DROP Score showed the best AUCs for the prediction of liver-related graft discard (0.82; p < 0.001) and macrovesicular steatosis ≥ 30% (0.71; p < 0.001). Patients exceeding the DROP 90th centile had the worse post-LT results (3-month graft loss: 82.8%; log-rank P = 0.024).The DROP score represents a valuable tool to predict the risk of liver function-related graft discard, steatosis, and early post-LT graft survival rates. Studies focused on the validation of this score in other geographical settings are required.

Lai, Q., Ghinolfi, D., Avolio, A. W., Manzia, T. M., Mennini, G., Melandro, F., Frongillo, F., Pellicciaro, M., Larghi Laureiro, Z., Aglietti, R., Franco, A., Quaranta, C., Tisone, G., Agnes, S., Rossi, M., De Simone, P., Proposal and validation of a liver graft discard score for liver transplantation from deceased donors: a multicenter Italian study, <<UPDATES IN SURGERY>>, 2022; 74 (2): 491-500. [doi:10.1007/s13304-022-01262-0] [http://hdl.handle.net/10807/209162]

Proposal and validation of a liver graft discard score for liver transplantation from deceased donors: a multicenter Italian study

Avolio, A. W.
Conceptualization
;
Frongillo, F.
Data Curation
;
Franco, A.
Data Curation
;
Agnes, S.
Writing – Review & Editing
;
2022

Abstract

Several studies have explored the risk of graft dysfunction after liver transplantation (LT) in recent years. Conversely, risk factors for graft discard before or at procurement have poorly been investigated. The study aimed at identifying a score to predict the risk of liver-related graft discard before transplantation. Secondary aims were to test the score for prediction of biopsy-related negative features and post-LT early graft loss. A total of 4207 donors evaluated during the period January 2004–Decemeber 2018 were retrospectively analyzed. The group was split into a training set (n = 3,156; 75.0%) and a validation set (n = 1,051; 25.0%). The Donor Rejected Organ Pre-transplantation (DROP) Score was proposed: − 2.68 + (2.14 if Regional Share) + (0.03*age) + (0.04*weight)-(0.03*height) + (0.29 if diabetes) + (1.65 if anti-HCV-positive) + (0.27 if HBV core) − (0.69 if hypotension) + (0.09*creatinine) + (0.38*log10AST) + (0.34*log10ALT) + (0.06*total bilirubin). At validation, the DROP Score showed the best AUCs for the prediction of liver-related graft discard (0.82; p < 0.001) and macrovesicular steatosis ≥ 30% (0.71; p < 0.001). Patients exceeding the DROP 90th centile had the worse post-LT results (3-month graft loss: 82.8%; log-rank P = 0.024).The DROP score represents a valuable tool to predict the risk of liver function-related graft discard, steatosis, and early post-LT graft survival rates. Studies focused on the validation of this score in other geographical settings are required.
Inglese
Lai, Q., Ghinolfi, D., Avolio, A. W., Manzia, T. M., Mennini, G., Melandro, F., Frongillo, F., Pellicciaro, M., Larghi Laureiro, Z., Aglietti, R., Franco, A., Quaranta, C., Tisone, G., Agnes, S., Rossi, M., De Simone, P., Proposal and validation of a liver graft discard score for liver transplantation from deceased donors: a multicenter Italian study, <<UPDATES IN SURGERY>>, 2022; 74 (2): 491-500. [doi:10.1007/s13304-022-01262-0] [http://hdl.handle.net/10807/209162]
File in questo prodotto:
File Dimensione Formato  
Lai_Avolio_Liver-GRAFT-DISCHARGE-SCORE_2022.pdf

embargo fino al 02/06/2022

Descrizione: FULL PAPER
Tipologia file ?: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 786.07 kB
Formato Adobe PDF
786.07 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/209162
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact