The new liver allocation score for transplantation is validated and improved transplant survival benefit in Germany but not in the United Kingdom.
Schrem H, Focken M, et al.Liver Transplantation 2016; 22(6): 743-756.
Aims
To develop and validate a prognostic model for the prediction of 90-day mortality after liver transplantation using pretransplant donor and recipient variables.
Interventions
The cohort was randomised into training and validation groups and candidate variables were used for prognostic model design. Model development and internal validation was used using the Hannover dataset for initial validation of the liver allocation score (LivAS). The Kiel and Birmingham cohorts were used as external validation groups to assess the validity of the sample.
Participants
Prospectively collected data on liver transplants performed in recipients aged ≥ 17 years in Hannover (n=770), Kiel (n=234), and Birmingham (n=829).
Outcomes
The primary outcomes measured were 90-day mortality and survival.
Follow-up
90 days
CET Conclusions
This retrospective analysis reported aimed to develop a new prognostic model to predict 90-day mortality after liver transplantation based on donor and recipient data in Germany and the UK. A cohort from one German centre was randomised to an internal training and validation set. A cohort from another German centre was used for external validation and a UK cohort was used for further external validation. Donor steatosis was a significant variable in the prognostic modelling and the amount of donor steatosis evaluated by experienced transplant pathologists in different centres using the same methodology. The prognostic model could be validated in the two German populations and the authors suggest that such a model could possibly improve the German allocation policies.
Quality notes
Quality assessment not appropriate
Trial registration
None