Pre-transplant Biomarkers of Immune Dysfunction Improve Risk Assessment of Post-transplant Mortality Compared to Conventional Clinical Risk Scores.
Publication/Presentation Date
2-21-2023
Abstract
INTRODUCTION: There is a critical need to accurately stratify liver transplant (LT) candidates' risk of post-LT mortality prior to LT to optimize patient selection and avoid futility. Here, we compare previously described
METHODS: LIFI was compared to MELD, MELD-Na, MELD 3.0, D-MELD, MELD-GRAIL, MELD-GRAIL-Na, UCLA-FRS, BAR, SOFT, P-SOFT, and LDRI scores on 289 LT recipients based on waitlist data at the time of LT. Survival, hazard of early post-LT death, and discrimination power (C-statistic) were assessed.
RESULTS: LIFI showed superior discrimination (highest C-statistic) for post-LT mortality when compared to all other risk scores, irrespective of biologic MELD. On univariate analysis, the LIFI showed a significant correlation with mortality 6-months, as well as 1-, 3-, and 5-years.
CONCLUSIONS: LIFI, which measures pre-LT biomarkers of immune dysfunction, more accurately predicts risk of post-LT futility compared with current clinical predictive models. Pre-LT assessment of immune dysregulation may be critical in predicting mortality after LT and may optimize selection of candidates with lowest risk of futile outcomes.
ISSN
2693-5015
Published In/Presented At
Medina-Morales, J. E., Panayotova, G. G., Nguyen, D. T., Graviss, E. A., Prakash, G. S., Marsh, J. A., Simonishvili, S., Shah, Y., Ayorinde, T., Qin, Y., Jin, L., Zoumpou, T., Minze, L. J., Paterno, F., Amin, A., Riddle, G. L., Ghobrial, R. M., Guarrera, J. V., & Lunsford, K. E. (2023). Pre-transplant Biomarkers of Immune Dysfunction Improve Risk Assessment of Post-transplant Mortality Compared to Conventional Clinical Risk Scores. Research square, rs.3.rs-2548184. https://doi.org/10.21203/rs.3.rs-2548184/v2
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
36798404
Department(s)
Administration and Leadership
Document Type
Article