Validation of the Balance of Risk as a Predictor of Liver Transplant Survival in a Spanish Population.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 29 01 2020
accepted: 06 02 2020
pubmed: 1 4 2020
medline: 5 11 2020
entrez: 1 4 2020
Statut: ppublish

Résumé

The Balance of Risk (BAR) score is a simple test that combines donor and recipient variables to predict liver transplant success. It has been validated in different publications, with cut-off points of between 15 and 18 points proposed depending on the region. The aim of this study is to test the validity of the BAR score and to find the optimal cut-off point for our population. A retrospective cohort of 164 liver transplant patients was selected between January 2012 and July 2019. All were older than 18 years and were treated in a Spanish tertiary-level hospital. The receiver operating characteristic curve between BAR and 5-year survival yields a result of 0.622 (P = .046), placing the cut-off point at ≥7 (sensitivity 61.5%, specificity 61.6%). Patients with a BAR score <7 and a BAR score ≥7 have an estimated 5-year survival of 53.91 vs 47.51 months, respectively (log rank = .032). The only 2 variables associated with increased survival were a BAR score of <7 (hazard ratio = 2.566; P < .001) and a body mass index <30 (hazard ratio = 6.667; P < .001). A low BAR score correlates well with liver transplant survival at 5 years. The BAR is a simple tool that should be used for donor-recipient matching. Due to the characteristics, resources, and population in our environment, a BAR score of 7 would be the optimum cut-off point for a liver transplant.

Sections du résumé

BACKGROUND BACKGROUND
The Balance of Risk (BAR) score is a simple test that combines donor and recipient variables to predict liver transplant success. It has been validated in different publications, with cut-off points of between 15 and 18 points proposed depending on the region. The aim of this study is to test the validity of the BAR score and to find the optimal cut-off point for our population.
MATERIALS AND METHODS METHODS
A retrospective cohort of 164 liver transplant patients was selected between January 2012 and July 2019. All were older than 18 years and were treated in a Spanish tertiary-level hospital.
RESULTS RESULTS
The receiver operating characteristic curve between BAR and 5-year survival yields a result of 0.622 (P = .046), placing the cut-off point at ≥7 (sensitivity 61.5%, specificity 61.6%). Patients with a BAR score <7 and a BAR score ≥7 have an estimated 5-year survival of 53.91 vs 47.51 months, respectively (log rank = .032). The only 2 variables associated with increased survival were a BAR score of <7 (hazard ratio = 2.566; P < .001) and a body mass index <30 (hazard ratio = 6.667; P < .001).
CONCLUSIONS CONCLUSIONS
A low BAR score correlates well with liver transplant survival at 5 years. The BAR is a simple tool that should be used for donor-recipient matching. Due to the characteristics, resources, and population in our environment, a BAR score of 7 would be the optimum cut-off point for a liver transplant.

Identifiants

pubmed: 32224014
pii: S0041-1345(20)30253-0
doi: 10.1016/j.transproceed.2020.02.059
pii:
doi:

Types de publication

Journal Article Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1481-1485

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Enrique Toledo (E)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain. Electronic address: enrique.toledo@scsalud.es.

Sonia Castanedo (S)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Erik G Tolaretxipi (EG)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Ana Lozano (A)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Juan Echeverri (J)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Roberto Fernández-Santiago (R)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Edward J Anderson (EJ)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Federico Castillo (F)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Juan Carlos Rodríguez-Sanjuan (JC)

General Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain; Universidad de Cantabria, Cantabria, Spain.

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Classifications MeSH