Scoring short‐term mortality after liver transplantation

Liver transplantation can prolong survival and improve the quality of life of patients with end‐stage liver disease. This study retrospectively reviewed the medical records of 149 patients who had received liver transplants in a tertiary care university hospital from January 2000 to December 2007. Demographic, clinical, and laboratory variables were recorded. Each patient was assessed by 4 scoring systems before transplantation and on postoperative days 1, 3, 7, and 14. The overall 1‐year survival rate was 77.9%. The Sequential Organ Failure Assessment (SOFA) score had better discriminatory power than the Child‐Pugh points, Model for End‐Stage Liver Disease score, and RIFLE (risk of renal dysfunction, injury to the kidney, failure of the kidney, loss of kidney function, and end‐stage kidney disease) criteria. Moreover, the SOFA score on day 7 post–liver transplant had the best Youden index and highest overall correctness of prediction for 3‐month (0.86, 93%) and 1‐year mortality (0.62, 81%). Cumulative survival rates at the 1‐year follow‐up after liver transplantation differed significantly (P < 0.001) between patients who had SOFA scores ≤ 7 on post–liver transplant day 7 and those who had SOFA scores > 7 on post–liver transplant day 7. In conclusion, of the 4 evaluated scoring systems, only the SOFA scores calculated before liver transplantation were statistically significant predictors of 3‐month and 1‐year posttransplant mortality. SOFA on post–liver transplant day 7 had the best discriminative power for predicting 3‐month and 1‐year mortality after liver transplantation. Liver Transpl 16:138–146, 2010. © 2010 AASLD.