Prognostic model for early acute rejection after liver transplantation
Gómez-Manero N, Herrero JI, Quiroga J, Sangro B, Pardo F, Cienfuegos JA, Prieto J.
Liver Unit, Clínica Universitaria de Navarra, Av Pio XII SIN, 31008 Pamplona, Spain
Hepatic graft rejection is a common complication after liver transplantation (LT), with a maximum incidence within the first weeks.
The identification of high-risk patients for early acute rejection (EAR) might be useful for clinicians. A series of 133 liver graft recipients treated with calcineurin inhibitors was retrospectively assessed to identify predisposing factors for EAR and develop a mathematical model to predict the individual risk of each patient. The incidence of EAR (< or =45 days after LT) was 35.3%. Multivariate analysis showed that recipient age, underlying liver disease, and Child's class before LT were independently associated with the development of EAR. Combining these 3 variables, the following risk score for the development of EAR was obtained: EAR score [F(x)] = 2.44 + (1.14 x hepatitis C virus cirrhosis) + (2.78 x immunologic cirrhosis) + (2.51 x metabolic cirrhosis)--(0.08 x recipient age in years) + (1.65 x Child's class A) [corrected]. Risk for rejection = e(F(x))/1 + e(F(x)).
The combination of age, cause of liver disease, and Child's class may allow us to predict the risk for EAR.
CITATION Liver Transpl. 2001 Mar;7(3):246-54