Prediction of Graft Survival Post-liver Transplantation by L-GrAFT Risk Score Model, EASE Score, MEAF Scoring, and EAD

Shirui Chen; Tielong Wang; Tao Luo; Shujiao He; Changjun Huang; Zehua Jia; Liqiang Zhan; Dongping Wang; Xiaofeng Zhu; Zhiyong Guo; Xiaoshun He

doi:10.3389/fsurg.2021.753056

Prediction of Graft Survival Post-liver Transplantation by L-GrAFT Risk Score Model, EASE Score, MEAF Scoring, and EAD

Front Surg. 2021 Nov 19:8:753056. doi: 10.3389/fsurg.2021.753056. eCollection 2021.

Authors

Shirui Chen^{1

2

3}, Tielong Wang^{1

2

3}, Tao Luo^{1

2

3}, Shujiao He^{1

2

3}, Changjun Huang^{1

2

3}, Zehua Jia^{1

2

3}, Liqiang Zhan^{1

2

3}, Dongping Wang^{1

2

3}, Xiaofeng Zhu^{1

2

3}, Zhiyong Guo^{1

2

3}, Xiaoshun He^{1

2

3}

Affiliations

¹ Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
² Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China.
³ Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, China.

Abstract

Background: Early allograft dysfunction (EAD) is correlated with poor patient or graft survival in liver transplantation. However, the power of distinct definitions of EAD in prediction of graft survival is unclear. Methods: This retrospective, single-center study reviewed data of 677 recipients undergoing orthotopic liver transplant between July 2015 and June 2020. The following EAD definitions were compared: liver graft assessment following transplantation (L-GrAFT) risk score model, early allograft failure simplified estimation score (EASE), model for early allograft function (MEAF) scoring, and Olthoff criteria. Risk factors for L-GrAFT₇ high risk group were evaluated with univariate and multivariable logistic regression analysis. Results: L-GrAFT₇ had a satisfied C-statistic of 0.87 in predicting a 3-month graft survival which significantly outperformed MEAF (C-statistic = 0.78, P = 0.01) and EAD (C-statistic = 0.75, P < 0.001), respectively. L-GrAFT₁₀, EASE was similar to L-GrAFT₇, and they had no statistical significance in predicting survival. Laboratory model for end-stage liver disease score and cold ischemia time are risk factors of L-GrAFT₇ high-risk group. Conclusion: L-GrAFT₇ risk score is capable for better predicting the 3-month graft survival than the MEAF and EAD in a Chinese cohort, which might standardize assessment of early graft function and serve as a surrogate endpoint in clinical trial.

Keywords: graft survival; machine perfusion; orthotopic liver transplantation; patient survivability; risk factor; risk prediction model.