Predictive score for immediate extubation after liver transplantation

2020 ◽  
Author(s):  
Aphichat Suphathamwit ◽  
Orawan Pongraweewan ◽  
Samonporn Lakkam ◽  
Chutwichai Tovikkai
Keyword(s):  
Liver Transplantation ◽  
Predictive Score ◽  
Immediate Extubation

Predictors of Success of Immediate Tracheal Extubation in Living Donor Liver Transplantation Recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
D G M Ibrahim ◽  
G F Zaki ◽  
E M K Aboseif ◽  
D M A Elfawy ◽  
A M H Abdou
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Tracheal Extubation ◽  
Serum Lactate ◽  
Predictors Of Success ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Duration Of Surgery ◽  
Immediate Extubation

Abstract Background Early tracheal extubation of recipients following liver transplantation (LT) has been promoted and gradually replacing standard postoperative prolonged mechanical ventilation, possibly contributing to better graft and patient survival and reduced costs. There are no universally accepted predictors of success of immediate extubation in LT recipients. We hypothesized a number of factors as predictors of successful immediate tracheal extubation in living donor liver transplantation (LDLT) recipients. Aim The aim of this study was to evaluate the validity of the following hypothesized factors: Model for end stage liver disease (MELD) score, duration of surgery, number of intraoperatively transfused packed red blood cells (RBCs) units and end of surgery (EOS) serum lactate, as predictors of success of immediate tracheal extubation in living donor liver transplantation (LDLT) recipients. Methods In this prospective clinical trial, perioperative data of adult LDLT recipients were recorded. “Immediate extubation” was defined as tracheal extubation immediately and up to 1 hour postransplant in the operating room. Patients were divided into; extubated group who were successfully extubated with no need for reintubation, and non-extubated group who failed to meet criteria of extubation or were re-intubated within 4 hours of extubation. Results Of 64 patients, 50 (76.9%) were extubated early after LDLT while 14 (23.07%) were transported to the intensive care unit (ICU) intubated. After data analysis, it was found that EOS serum lactate, duration of surgery and number of packed RBCs units transfused intraoperatively, were good predictors of success of immediate extubation, while MELD scores had no statistically significant impact on the results. In addition, other factors such as EOS urine output and pH were shown to have significantly affected the results. Conclusions EOS serum lactate, duration of surgery and number of packed RBCs units transfused were predictors of post-transplant early extubation.

A New Formula as a Predictive Score of Post–Liver Transplantation Outcome: Postoperative MELD-Lactate

2014 ◽  
Vol 46 (5) ◽  
pp. 1407-1412 ◽  
Author(s):  
N.M. Cardoso ◽  
T. Silva ◽  
A. Basile-Filho ◽  
E.D. Mente ◽  
O. Castro-e-Silva
Keyword(s):  
Liver Transplantation ◽  
Predictive Score ◽  
New Formula

CHRONIC RENAL DYSFUNCTION AFTER LIVER TRANSPLANTATION: RISK FACTORS AND A NEW PREDICTIVE SCORE

2009 ◽  
Vol 41 ◽  
pp. S26
Author(s):  
F. Gentili ◽  
M. Giusto ◽  
I. Loria ◽  
C. Lucidi ◽  
S. Ginanni Corradini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Renal Dysfunction ◽  
Predictive Score

Immediate Extubation of Children Following Liver Transplantation Is Safe and May Be Beneficial

2005 ◽  
Vol 80 (7) ◽  
pp. 959-963 ◽  
Author(s):  
Moira E. O???Meara ◽  
Simon M. Whiteley ◽  
Jane M. Sellors ◽  
Jeremy M. Luntley ◽  
Suzanne Davison ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Immediate Extubation

464 CHRONIC RENAL DYSFUNCTION AFTER LIVER TRANSPLANTATION: RISK FACTORS AND A NEW PREDICTIVE SCORE

2009 ◽  
Vol 50 ◽  
pp. S175
Author(s):  
F. Gentili ◽  
M. Giusto ◽  
I. Loria ◽  
S. Ginanni Corradini ◽  
A. Molinaro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Renal Dysfunction ◽  
Predictive Score

scholarly journals Re-evaluation of the predictive score for 6-month graft survival in living donor liver transplantation in the modern era

2014 ◽  
Vol 20 (3) ◽  
pp. 323-332 ◽  
Author(s):  
Tomoharu Yoshizumi ◽  
Toru Ikegami ◽  
Yuki Bekki ◽  
Mizuki Ninomiya ◽  
Hideaki Uchiyama ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Graft Survival ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Predictive Score ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Modern Era

Tu1027 A New Formula As a Predictive Score of Post-Liver Transplantation Outcome: Postoperative MELD Lactate

2013 ◽  
Vol 144 (5) ◽  
pp. S-1035
Author(s):  
Nathalia M. Cardoso ◽  
Orlando Castro-e-Silva ◽  
Anibal Basile-Filho
Keyword(s):  
Liver Transplantation ◽  
Predictive Score ◽  
New Formula

Liver transplant length of stay (LOS) index: A novel predictive score for hospital length of stay following liver transplantation

2017 ◽  
Vol 31 (12) ◽  
pp. e13141 ◽  
Author(s):  
Abbas Rana ◽  
Ellen D. Witte ◽  
Karim J. Halazun ◽  
Gagan K. Sood ◽  
Ayse L. Mindikoglu ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Length Of Stay ◽  
Liver Transplant ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Predictive Score

scholarly journals SURVIVAL TREE SCORE: A NOVEL APPROACH TO PREDICT MORTALITY IN CIRRHOTIC PATIENTS

2020 ◽  
Vol 38 (4) ◽  
pp. 506
Author(s):  
Samanta Teixeira BASTO ◽  
Emília Matos do NASCIMENTO ◽  
Basilio De Bragança PEREIRA ◽  
Joaquim RIBEIRO FILHO ◽  
Renata De Mello PEREZ ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Primary Root ◽  
Meld Score ◽  
Predictive Score ◽  
Disease Etiology ◽  
Tree Analysis ◽  
Cox Regression Analysis ◽  
Cirrhotic Patients ◽  
Survival Tree

Although Model for End-Stage Liver Disease (MELD) score is adopted worldwide for liver transplant allocation, but it has prognostic limitations. The aim of this study was to apply the survival tree analysis to evaluate interaction between variables related to mortality in cirrhotics patients enlisted for liver transplantation, and to develop a new mortality predictive score. Demographic, clinical and laboratory data of cirrhotic patients waiting for liver transplantation during a 12-year period were considered. Charts from 765 patients were reviewed. The interaction between prognostic covariates was obtained using a survival tree analysis. In order to develop the predictive score, Cox regression analysis was performed applying significant data obtained by the survival tree analysis. The prognostic covariates evaluated in the survival tree were MELD score, Child-Pugh score, serum sodium, viral disease etiology, hepatocellular carcinoma diagnosis and generated a coefficient for each. Based on the survival tree analysis, MELD = 15 was the primary root variable (p<0.001). The survival tree provided eight prognostic groups. The higher mortality hazard ratio (HR) risk was observed in the MELD >28 group (HR= 16.7).  The new score (Survival Tree Score – STS) was obtained according to the coefficients provided. The STS prognostic performance was superior to MELD score (AUROC 0.713 vs 0.653, p<0.001). STS, could be a useful tool to accurately identify individual mortality risk in advanced liver disease.

ALBI and PALBI Grades Are Associated with the Outcome of Patients with Stable Decompensated Cirrhosis

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10 ◽  
Author(s):  
Theodora Oikonomou ◽  
Ioannis Goulis ◽  
Petros Doumtsis ◽  
Theodora Tzoumari ◽  
Evangelos Akriviadis ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Prognostic Significance ◽  
Prognostic Scores ◽  
Predictive Score ◽  
Decompensated Cirrhosis ◽  
Survival Times ◽  
Grade 3 ◽  
Ctp Score ◽  
End Stage ◽  
Better Than

Introduction and aim. Studies carried out mainly in patients with hepatocellular carcinoma (HCC), have shown the prognostic significance of albumin-bilirubin (ALBI) grade. Recently, another predictive score incorporating platelet count into ALBI, PALBI grade, was introduced in patients with HCC. Aim of the study. We evaluated the ability of ALBI and PALBI grades in predicting the outcome (mortality/ liver transplantation) of patients with stable decompensated cirrhosis with various etiology of liver diseases. Materials and methods. We prospectively studied 325 patients with stable decompensated cirrhosis awaiting liver transplantation. Their clinical and laboratory characteristics were recorded including albumin, bilirubin levels, platelets. We estimated ALBI and PALBI grades for every patient. Conventional prognostic scores were also evaluated; Child-Pugh (CTP), Model for End stage Liver Disease (MELD). We followed them up and recorded their outcome. Results. Beyond MELD and CTP, ALBI and PALBI grades proved significant factors associated with the outcome (HR: 2.13, 95%CI [1.59, 2.85], p<0.001 and HR: 2.06, 95%CI [1.47, 2.9], p<0.001, respectively), and their predictive capability was established (ROC analysis; AUC: 0.695, 95% CI [0.634, 0.755] and AUC: 0.683, 95% CI [0.621, 0.744], respectively). ALBI and PALBI performed better than CTP score (p=0.0044 and p=0.014, respectively). Categorization of our patients into three ALBI groups detected statistically different survival times. Accordingly, PALBI grade 3 compared to those with PALBI grade 1 and 2 patients, had worse outcome and significantly higher frequency of cirrhosis-related complications. Conclusions. ALBI and PALBI grades were validated and can be used to predict the outcome in patients with stable decompensated cirrhosis.

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