Prognostic model for early acute rejection after liver transplantation
Gómez-Manero N, Herrero JI, Quiroga J, Sangro B, Pardo F, Cienfuegos JA, Prieto J.
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.
CITA DEL ARTÍCULO Liver Transpl. 2001 Mar;7(3):246-54