Prediction of 6-month survival after liver transplantation using Cox regression

Transplant Proc. 2004 Apr;36(3):529-32. doi: 10.1016/j.transproceed.2004.02.024.

Abstract

Background: The outcome of liver transplantation (LTx) has been correlated with several donor and recipient factors.

Methods: A database of 191 consecutive LTx cases was analyzed using Kaplan-Meier and Cox regression statistics based on 80 variables. To avoid additional effects of late events on patient survival, the chosen endpoint was 6 months. Data were evaluated using SPSS statistical software.

Results: Kaplan-Meier analysis revealed a difference in 1- to 6-month graft survival between patients transplanted with organs from donors older versus younger than 60 years (Breslow, P <.01). Differences in 1- to 6-month graft survivals were observed between patients listed as UNOS status 3, 2B, 2A, and 1: the outcomes for UNOS status 2B versus UNOS status 2A and UNOS status 2B versus status 1 were significant (P <.05). Differences in 1- to 6-month graft survival rates were found between patients with versus without sepsis (P <.05), and with versus without rejection episodes (P <.01). Cox regression analysis revealed only three of the variables to be independent prognostic predictors of graft failure: donor age; postoperative septic status; and rejection. The best mathematical multivariate Cox regression model linked donor age + donor Na + rejection + sepsis to 1- to 6-month graft survival (chi-square = 29.06, P <.001).

Conclusion: Factors predictive of 1- to 6-month graft survival after liver transplantation include donor age; UNOS status; sepsis; and rejection.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Chi-Square Distribution
  • Databases, Factual
  • Follow-Up Studies
  • Humans
  • Liver Transplantation / mortality*
  • Middle Aged
  • Predictive Value of Tests
  • Regression Analysis
  • Survival Analysis
  • Time Factors
  • Tissue Donors / classification*
  • Treatment Failure
  • Treatment Outcome