PRIMARY BILIARY-CIRRHOSIS - DUTCH APPLICATION OF THE MAYO MODEL BEFORE AND AFTER ORTHOTOPIC LIVER-TRANSPLANTATION

Background/Aims: A retrospective study of primary biliary cirrhosis (P BC) was performed to study the Original Mayo Model for predicting surv ival by a Dutch data-set of patients, presentation of disease progress ion; assessment of liver transplantation, prediction of post-transplan tation survival; and the addition of two laboratory variables to the O riginal Mayo Model. Materials and Methods: Survival of 83 patients, 37 of whom underwent transplantation, were studied. Mean follow-up was 6 .0+/-0.45 SEM years. Risk score at diagnosis, platelet count, and seru m sodium were analyzed in a Cox model. Results: The Original Mayo Mode l estimated survival for low-, medium-, and high-risk groups accuratel y and it also presented disease progression. Baseline Mayo risk score in a Cox model had a regression coefficient of 1.01, indicating an exc ellent predictor p < 0.0001. Platelet count was a predictor of surviva l (p < 0.002), whereas serum sodium did not (p = 0.67). A new model co mbined of the Original Mayo risk score and platelet count predicted su rvival in high-risk patients somewhat better compared to the Original Mayo Model. With both models, liver transplantation had a significant beneficial effect on, survival (p < 0.001). The scores revealed no sig nificant influence (p = 0.47) for overall post-transplantation surviva l. Conclusions: The Original Mayo Model remains the model of choice fo r patients with PBC for prognostication from 3-8 years, is a useful to ol in the assessment of liver transplantation but not an indicator of post-transplantation survival. Platelet count showed to have additiona l prognostic value. A new model combined of platelet count and the Ori ginal Mayo risk score did predict survival in high-risk groups slightl y better compared to the Original Mayo Model.