Rana et al developed a preallocation score for Predicting Survival Outcomes Following Liver Transplantation (P-SOFT). This can help to determine which patients are likely to survive following surgery. The authors are from Columbia University College of Physicians and Surgeons in New York City.
Patient selection: candidate for liver transplant
Outcome: post-transplant survival
Parameters:
(1) age in years
(2) body mass index (BMI)
(3) number of previous liver transplants
(4) history of abdominal surgery
(5) serum albumin in g/dL
(6) dialysis prior to transplantation
(7) pretransplant status
(8) MELD score
(9) life support pretransplant
(10) encephalopathy
(11) portal vein thrombosis
(12) ascites pretransplantation
|
Parameter |
Finding |
Points |
|
age in years |
<= 60 years of age |
0 |
|
|
> 60 years of age |
4 |
|
body mass index |
<= 35 kg per sq m |
0 |
|
|
> 35 kg per sq m |
2 |
|
number of previous transplants |
none |
0 |
|
|
1 |
9 |
|
|
2 or more |
14 |
|
history of abdominal surgery |
no |
0 |
|
|
yes |
2 |
|
serum albumin |
>= 2.0 g/dL |
0 |
|
|
< 2.0 g/dL |
2 |
|
dialysis prior to transplant |
no |
0 |
|
|
yes |
3 |
|
pretransplant status |
elective |
0 |
|
|
admitted to hospital |
3 |
|
|
in ICU |
6 |
|
MELD score |
<= 30 |
0 |
|
|
> 30 |
4 |
|
life support pretransplant |
no |
0 |
|
|
yes |
9 |
|
encephalopathy |
no |
0 |
|
|
yes |
2 |
|
portal vein thrombosis |
no |
0 |
|
|
yes |
5 |
|
ascites pretransplant |
no |
0 |
|
|
yes |
3 |
total score =
= SUM(points for all 12 parameters)
Interpretation:
• minimum score: 0
• maximum score: 56
• The higher the score the greater the risk.
|
Total Score |
Risk Group |
Survival at 3 Months |
|
0 to 5 |
low |
97% |
|
6 to 15 |
low to moderate |
94% |
|
16 to 35 |
moderate to high |
82% |
|
36 to 40 |
high |
53% |
|
>= 41 |
futile |
41% |
Specialty: Gastroenterology, Surgery, general
