L-GrAFT 7 has High Accuracy in Predicting Early Allograft Failure after Liver Transplantation: A Multicenter Cohort Study in China.

Autor:	Li S; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., Luo Q; General Surgery Dept. 1, Zhongshan People's Hospital, Zhongshan Hospital of Sun Yat-Sen University, Zhongshan, Guangdong, China., Chen S; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., Jia Z; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., Wang T; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., Yu X; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., Wang W; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., YuyiZhang; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., Zhu J; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., Deng F; Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Foshan, Guangdong, China., Sun Q; General Surgery Dept. 1, Zhongshan People's Hospital, Zhongshan Hospital of Sun Yat-Sen University, Zhongshan, Guangdong, China., Guo Z; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China., He X; Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China.; Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, Guangdong, China.; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong, China.
Jazyk:	angličtina
Zdroj:	Journal of clinical and translational hepatology [J Clin Transl Hepatol] 2024 Jan 28; Vol. 12 (1), pp. 62-69. Date of Electronic Publication: 2023 Aug 17.
DOI:	10.14218/JCTH.2023.00178
Abstrakt:	Background and Aims: Increasing utilization of extended criteria donor leads to an increasing rate of early allograft failure after liver transplantation. However, consensus of definition of early allograft failure is lacking. Methods: A retrospective, multicenter study was performed to validate the Liver Graft Assessment Following Transplantation (L-GrAFT) risk model in a Chinese cohort of 942 adult patients undergoing primary liver transplantation at three Chinese centers. L-GrAFT (L-GrAFT 7 and L-GrAFT 10 ) was compared with existing models: the Early Allograft Failure Simplified Estimation (EASE) score, the model of early allograft function (MEAF), and the Early Allograft Dysfunction (EAD) model. Univariate and multivariate logistic regression were used to find risk factors of L-GrAFT high-risk group. Results: L-GrAFT 7 had an area under the curve of 0.85 in predicting 90-day graft survival, significantly superior to MEAF [area under the curve (AUC=0.78, p =0.044)] and EAD (AUC=0.78, p =0.006), while there was no statistical significance between the predicting abilities of L-GrAFT 7 and EASE (AUC=0.84, p >0.05). Furthermore, L-GrAFT 7 maintains good predicting ability in the subgroup of high-donor risk index (DRI) cases (AUC=0.83 vs. MEAF, p =0.007 vs. EAD, p =0.014) and recipients of donors after cardiac death (AUC=0.92 vs. EAD, p <0.001). Through multivariate analysis, pretransplant bilirubin level, units of packed red blood cells, and the DRI score were selected as independent risk factors of a L-GrAFT 7 high-risk group. Conclusions: The accuracy of L-GrAFT 7 in predicting early allograft failure was validated in a Chinese multicenter cohort, indicating that it has the potential to become an accurate endpoint of clinical practice and transitional study of machine perfusion. Competing Interests: The authors have no conflict of interests related to this publication. (© 2024 Authors.)
Databáze:	MEDLINE
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