The Liver Retransplantation Risk Score: a prognostic model for survival after adult liver retransplantation

Summary High‐risk combinations of recipient and graft characteristics are poorly defined for liver retransplantation (reLT) in the current era. We aimed to develop a risk model for survival after reLT using data from the European Liver Transplantation Registry, followed by internal and external vali...

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Published in:Transplant international 2021-10, Vol.34 (10), p.1928-1937
Main Authors: Brüggenwirth, Isabel M. A., Werner, Maureen J. M., Adam, René, Polak, Wojciech G., Karam, Vincent, Heneghan, Michael A., Mehrabi, Arianeb, Klempnauer, Jürgen L., Paul, Andreas, Mirza, Darius F., Pratschke, Johann, Salizzoni, Mauro, Cherqui, Daniel, Allison, Michael, Soubrane, Olivier, Staffa, Steven J., Zurakowski, David, Porte, Robert J., Meijer, Vincent E.
Format: Article
Language:English
Subjects:
Decision making
European Liver and Intestine Transplant Association
European Liver Transplant Registry
graft survival
Grafting
Ischemia
Liver
Liver diseases
Liver transplantation
Liver transplants
Original
Risk
risk assessment
Survival
Transplantation
Transplants
Transplants & implants
United Network for Organ Sharing
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Summary:Summary High‐risk combinations of recipient and graft characteristics are poorly defined for liver retransplantation (reLT) in the current era. We aimed to develop a risk model for survival after reLT using data from the European Liver Transplantation Registry, followed by internal and external validation. From 2006 to 2016, 85 067 liver transplants were recorded, including 5581 reLTs (6.6%). The final model included seven predictors of graft survival: recipient age, model for end‐stage liver disease score, indication for reLT, recipient hospitalization, time between primary liver transplantation and reLT, donor age, and cold ischemia time. By assigning points to each variable in proportion to their hazard ratio, a simplified risk score was created ranging 0–10. Low‐risk (0–3), medium‐risk (4–5), and high‐risk (6–10) groups were identified with significantly different 5‐year survival rates ranging 56.9% (95% CI 52.8–60.7%), 46.3% (95% CI 41.1–51.4%), and 32.1% (95% CI 23.5–41.0%), respectively (P 
ISSN:0934-0874
1432-2277
DOI:10.1111/tri.13956