A PROGNOSTIC MODEL FOR THE OUTCOME OF LIVER-TRANSPLANTATION IN PATIENTS WITH CHOLESTATIC LIVER-DISEASE

We studied the outcome of 436 patients with primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC) who underwent orthotopic liver transplant (OLT) at three major liver transplant centers. Univa riate predictors of outcome included age, Karnofsky score, Child's cla ss, Mayo risk score, United Network for Organ Sharing (UNOS) status, n utritional status, serum albumin, serum bilirubin, international norma lized ratio, and the presence of ascites, encephalopathy, renal failur e (serum creatinine > 2 mg/dL), and edema refractory to diuretics. Usi ng these predictors, we developed a four variable mathematical prognos tic model to help the Liver transplant physician predict the following : 1) the amount of intraoperative blood loss; 2) the number of days in the intensive care unit (ICU); and 3) severe complications after surg ery. The model uses age, renal failure, Child's class, and United Netw ork for Organ Sharing status. This study is the first to model the out come of liver transplant in patients with a specific etiology of chron ic liver disease (PBC or PSC). The model may be used to help select pa tients for OLT and to plan the timing of their transplantation.