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Prognostic value of preoperatively obtained clinical and laboratory data in predicting survival following orthotopic liver transplantation

Cuervas Mons, V and Millan, I and Gavaler, JS and Starzl, TE and van Thiel, DH (1986) Prognostic value of preoperatively obtained clinical and laboratory data in predicting survival following orthotopic liver transplantation. Hepatology, 6 (5). 922 - 927. ISSN 0270-9139

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Abstract

Twenty‐seven clinical and laboratory data and the subsequent clinical course of 93 consecutive adult patients who underwent orthotopic liver transplantation for various chronic advanced liver diseases were analyzed retrospectively to assess the risk factors of early major bacterial infection and death after the procedure. Forty‐one patients (44%) had early major bacterial infection during hospitalization for orthotopic liver transplantation. The mortality rate was 70.7% in patients with early major bacterial infection and was 7.7% in patients without early major bacterial infection (p < 0.001). Total serum bilirubin, total white blood cell count and polymorphonuclear cell count, IgG (all p < 0.05) and plasma creatinine level (p < 0.001) were higher in patients that developed early major bacterial infection than in those who did not. By step‐wise discriminant analysis, the strongest risk factor for early major bacterial infection was the serum creatinine level, which achieved an accuracy of 69% for a creatinine level greater than 1.58 mg per dl. Seven variables (ascites, hepatic encephalopathy, elevated white blood and polymorphonuclear cell count, decreased helper to suppressor T cell ratio and elevated plasma creatinine and bilirubin levels) were associated with a significant increased risk for death. A step‐wise discriminant analysis of these seven factors resulted in the demonstration of serum creatinine as the greatest risk factor for mortality. A preoperative serum creatinine either less than or greater than 1.72 mg per dl accurately predicts survival or death, respectively, in 79% of cases. These data suggest that the baseline preoperative serum creatinine level provides the best indication of the short‐term prognosis after liver transplantation than does any other preoperatively obtained index of the patient's status. Copyright © 1986 American Association for the Study of Liver Diseases


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Cuervas Mons, V
Millan, I
Gavaler, JS
Starzl, TEtes11@pitt.eduTES11
van Thiel, DH
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1986
Date Type: Publication
Journal or Publication Title: Hepatology
Volume: 6
Number: 5
Page Range: 922 - 927
DOI or Unique Handle: 10.1002/hep.1840060519
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0270-9139
Other ID: uls-drl:31735062119668, Starzl CV No. 684
Date Deposited: 08 Apr 2010 17:11
Last Modified: 02 Feb 2019 13:56
URI: http://d-scholarship.pitt.edu/id/eprint/4070

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