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Pre-transplant ALBI Grade 3 Is Associated with Increased Mortality After Liver Transplantation

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Abstract

Background

Although MELD score is a reliable tool for estimating mortality in the waiting list, criteria for preoperative prediction of survival after liver transplantation (LT) are lacking. ALBI score was validated as a prognostic marker for hepatocellular carcinoma patients undergoing transarterial chemoembolization, hepatic resection, and sorafenib treatment but not for LT outcomes yet. This study aimed to evaluate ALBI score as a prognostic factor in LT.

Methods

This is a single-center analysis of patients undergoing LT between October 2001 and June 2017. Primary endpoint was overall post-LT mortality. Secondary endpoint was 90-day mortality.

Results

Of all 301 patients included in this study, 185 (61.5%) were males. The median age was 54.1 ± 11.3 years. Univariate and multivariate analysis revealed that ALBI grade 3 (HR 1.836, 95% CI 1.154–2.921, p = 0.010), low serum albumin (HR 0.628, 95% CI 0.441–0.893, p = 0.010), black race (HR 2.431, 95% CI 1.160–5.092, p = 0.019), and elevated body mass index (HR 1.061, 95% CI 1.022–1.102, p = 0.002) all were associated with decreased overall survival following LT. Patients with both ALBI grade 3 (n = 25) and calculated MELD score ≥ 25 had the lowest overall survival (p < 0.001).

Discussion

ALBI grade 3 was related to lower post-LT survival and can be utilized as a tool for risk stratification in LT.

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Authors and Affiliations

  1. Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos 2350, 6th Floor, Room 600, Porto Alegre, 90035-903, Brazil

    Nicole Bernardi, Marcio F. Chedid, Tomaz J. M. Grezzana-Filho, Aljamir D. Chedid, Marcelo A. Pinto, Ian Leipnitz, João E. Prediger, Carolina Prediger, Ariane N. Backes, Thais O. Hammes, Lea T. Guerra & Cleber R. P. Kruel

  2. Division of Gastroenterology and Hepatology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

    Alexandre de Araujo & Mario R. Alvares-da-Silva

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  1. Nicole Bernardi
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Correspondence to Marcio F. Chedid.

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Bernardi, N., Chedid, M.F., Grezzana-Filho, T.J.M. et al. Pre-transplant ALBI Grade 3 Is Associated with Increased Mortality After Liver Transplantation. Dig Dis Sci 64, 1695–1704 (2019). https://doi.org/10.1007/s10620-019-5456-6

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  • DOI: https://doi.org/10.1007/s10620-019-5456-6

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