PMID- 16710854
OWN - NLM
STAT- MEDLINE
DCOM- 20061222
LR  - 20060529
IS  - 1527-6465 (Print)
IS  - 1527-6465 (Linking)
VI  - 12
IP  - 6
DP  - 2006 Jun
TI  - Quantitative survival model for short-term survival after adult-to-adult living 
      donor liver transplantation.
PG  - 904-11
AB  - Adult-to-adult living donor liver transplantation (ALDLT) has been accepted as an 
      important option for end-stage liver disease, but information regarding the risk 
      factors remains fragmentary. We aimed to establish a predictive model for 90-day 
      survival. In the first step, a total of 286 cases who had received primary ALDLT 
      using a right lobe graft between 1998 and 2004 were randomly divided into 2 
      cohorts at a ratio of 2:1 (191 vs. 95 recipients). The larger cohort of patients 
      was used to develop a model. The outcome was defined as 90-day survival, and a 
      total of 39 preoperative and operative variables, including the period of surgery 
      (1998-2001 vs. 2002-2004), were included using Cox's proportional hazard 
      regression model. Two mismatches of human leukocyte antigen (HLA) type DR (hazard 
      ratio [HR] = 4.45; confidence interval [CI] = 1.96-10.1), log(e)[blood loss 
      volume] (HR = 2.43; CI = 1.64-3.60), period of surgery (1998-2001 vs. 2002-2004) 
      (HR = 2.41; CI = 1.04-5.57), and log(e)[serum C-reactive protein or CRP] (HR = 
      1.64; CI = 1.13-2.38) were found to be independent risk factors. In the second 
      step, we tried to establish a realistic survival model. In this step, we created 
      2 models, 1 that used all 4 variables (model 1) and 1 (model 2) in which blood 
      loss volume was replaced with the past history of upper abdominal surgery and 
      Model for End-Stage Liver Disease (MELD) score (> or =25), both of which showed 
      associations with blood loss volume. These models were applied to the smaller 
      cohort of 95 patients. Receiver operating characteristic analyses demonstrated 
      that both models showed similar significant c-statistics (0.63 and 0.62, 
      respectively). In conclusion, model 2 can provide a rough estimation of the 
      90-day survival after ALDLT.
FAU - Tsunematsu, Ichiro
AU  - Tsunematsu I
AD  - Department of Transplantation and Immunology, Kyoto University, Kyoto, Japan.
FAU - Ogura, Yasuhiro
AU  - Ogura Y
FAU - Inoue, Kayoko
AU  - Inoue K
FAU - Koizumi, Akio
AU  - Koizumi A
FAU - Tanigawa, Nobuhiko
AU  - Tanigawa N
FAU - Tanaka, Koichi
AU  - Tanaka K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Liver Transpl
JT  - Liver transplantation : official publication of the American Association for the 
      Study of Liver Diseases and the International Liver Transplantation Society
JID - 100909185
SB  - IM
EIN - Liver Transpl. 2006 Aug;12(8):1307
MH  - Adult
MH  - Female
MH  - Humans
MH  - *Liver Transplantation
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - *Models, Biological
MH  - Survival/*physiology
EDAT- 2006/05/20 09:00
MHDA- 2006/12/23 09:00
CRDT- 2006/05/20 09:00
PHST- 2006/05/20 09:00 [pubmed]
PHST- 2006/12/23 09:00 [medline]
PHST- 2006/05/20 09:00 [entrez]
AID - 10.1002/lt.20743 [doi]
PST - ppublish
SO  - Liver Transpl. 2006 Jun;12(6):904-11. doi: 10.1002/lt.20743.