Clinical advances in prognostic factors and predictive methods of liver transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

BAI Keli , LI Yanhong ,  WANG Xiao

Department of Anesthesiology, West China hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Xiao, Email: 1490829116@qq.com

Keywords：

liver transplantation; prognosis; influence factors; model for end-stage liver disease

DOI：

10.7507/1007-9424.201908081

Video：

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Objective To figure out the factors affecting the prognosis of liver transplantation and the research progress on methods for predicting the prognosis of liver transplantation so as to provide guidance and reference for the distribution of liver sources and the perioperative treatment of liver transplantation.Method The literatures related to the factors influencing the prognosis of liver transplantation and the methods in predicting the prognosis were searched in the PubMed, CNKI, Wanfang, and other databases and the results were analyzed and summarized.Results The liver transplantation was an effective method in the treatment of end-stage liver diseases. The main factors affecting the prognosis of liver transplantation included the change of internal environment, systemic inflammatory response, and general systemic conditions. On the basis of Model for End-stage Liver Disease (MELD), the new prediction model built in combination with the blood sodium ion, lactate, muscle mass, or reticulocyte count and hemoglobin concentration had improved the prognostic prediction ability of liver transplantation.Conclusions It is possible to predict the prognosis of patients with liver transplantation more accurately by selecting a more targeted prediction model combined with the factors affecting the prognosis of liver transplantation. It might provide a reference for perioperative management and treatment and make the limited liver source play the most role and save more lives.

Citation： BAI Keli, LI Yanhong, WANG Xiao. Clinical advances in prognostic factors and predictive methods of liver transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(3): 383-388. doi: 10.7507/1007-9424.201908081 Copy

1.	Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg, 1973, 60(8): 646-649.
2.	Malinchoc M, Kamath PS, Gordon FD, et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology, 2000, 31(4): 864-871.
3.	Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology, 2001, 33(2): 464-470.
4.	Wiesner R, Edwards E, Freeman R, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology, 2003, 124(1): 91-96.
5.	Luo X, Leanza J, Massie AB, et al. MELD as a metric for survival benefit of liver transplantation. Am J Transplant, 2018, 18(5): 1231-1237.
6.	Myers RP, Tandon P, Ney M, et al. Validation of the five-variable Model for End-stage Liver Disease (5vMELD) for prediction of mortality on the liver transplant waiting list. Liver Int, 2014, 34(8): 1176-1183.
7.	Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology, 2006, 130(6): 1652-1660.
8.	Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med, 2008, 359(10): 1018-1026.
9.	Liver and Intestinal Organ Transplantation. Policy proposals: proposal to add serum sodium to the MELD score. http://optn.transplant.hrsa.gov/PublicComment/pubcommentPropSub. Accessed February 8, 2016.
10.	Nagai S, Chau LC, Schilke RE, et al. Effects of allocating livers for transplantation based on model for end-stage liver disease-sodium scores on patient outcomes. Gastroenterology, 2018, 155(5): 1451-1462.
11.	Atiemo K, Skaro A, Maddur H, et al. Mortality risk factors among patients with cirrhosis and a low model for end-stage liver disease sodium score (≤15): An analysis of liver transplant allocation policy using aggregated electronic health record data. Am J Transplant, 2017, 17(9): 2410-2419.
12.	Pozo-Laderas JC, Rodríguez-Perálvarez M, Muñoz-Villanueva MC, et al. Pretransplant predictors of early mortality in adult recipients of liver transplantation in the MELD-Na Era. Med Intensiva, 2019, 43(5): 261-269.
13.	Mihaylov P, Nagai S, Ekser B, et al. Prognostic impact of peritransplant serum sodium concentrations in liver transplantation. Ann Transplant, 2019, 24: 418-425.
14.	Kim S, Zerillo J, Tabrizian P, et al. Postoperative Meld-lactate and isolated lactate values as outcome predictors following orthotopic liver transplantation. Shock, 2017, 48(1): 36-42.
15.	Wu JF, Wu RY, Chen J, et al. Early lactate clearance as a reliable predictor of initial poor graft function after orthotopic liver transplantation. Hepatobiliary Pancreat Dis Int, 2011, 10(6): 587-592.
16.	Perilli V, Aceto P, Sacco T, et al. Usefulness of postreperfusion lactate clearance for predicting early graft recovery in liver transplant patients: a single center study. Minerva Anestesiol, 2018, 84(10): 1142-1149.
17.	Huh IY, Kim YK, Shin WJ, et al. Increased B-type natriuretic peptide during liver transplantation: relationship to invasively measured hemodynamic parameters. Transplant Proc, 2012, 44(5): 1318-1322.
18.	Mercantini P, Di Somma S, Magrini L, et al. Preoperative brain natriuretic peptide (BNP) is a better predictor of adverse cardiac events compared to preoperative scoring system in patients who underwent abdominal surgery. World J Surg, 2012, 36(1): 24-30.
19.	Toussaint A, Weiss E, Khoy-Ear L, et al. Prognostic value of preoperative brain natriuretic peptide serum levels in liver transplantation. Transplantation, 2016, 100(4): 819-824.
20.	Chae MS, Koo JM, Park CS. Predictive role of tntraoperative serum brain natriuretic peptide for early allograft dysfunction in living donor liver transplantation. Ann Transplant, 2016, 21: 538-549.
21.	Zhou L, Liu J, Luo F. Serum tumor markers for detection of hepatocellular carcinoma. World J Gastroenterol, 2006, 12(8): 1175-1181.
22.	Fu SJ, Zhao Q, Ji F, et al. Elevated preoperative serum gamma-glutamyltranspeptidase predicts poor prognosis for hepatocellular carcinoma after liver transplantation. Sci Rep, 2016, 6: 28835.
23.	蔡尚坤, 蒋利, 杨家印. 术前血清谷氨酰胺转肽酶与肝癌患者活体肝移植术后生存的关系. 中华普通外科杂志, 2017, 32(11): 945-948.
24.	Hasuike Y, Nonoguchi H, Tokuyama M, et al. Serum ferritin predicts prognosis in hemodialysis patients: the Nishinomiya study. Clin Exp Nephrol, 2010, 14(4): 349-355.
25.	Weismüller TJ, Manns MP, Strassburg CP. Ferritin and liver allocation? Impact on mortality not only on the waiting list but also after orthotopic liver transplantation should be considered. Hepatology, 2010, 52(1): 392-393.
26.	Weismüller TJ, Kirchner GI, Scherer MN, et al. Serum ferritin concentration and transferrin saturation before liver transplantation predict decreased long-term recipient survival. Hepatology, 2011, 54(6): 2114-2124.
27.	Amulic B, Cazalet C, Hayes GL, et al. Neutrophil function: from mechanisms to disease. Annu Rev Immunol, 2012, 30: 459-489.
28.	McDonald B, Urrutia R, Yipp BG, et al. Intravascular neutrophil extracellular traps capture bacteria from the bloodstream during sepsis. Cell Host Microbe, 2012, 12(3): 324-333.
29.	Kalra A, Wedd JP, Bambha KM, et al. Neutrophil-to-lymphocyte ratio correlates with proinflammatory neutrophils and predicts death in low model for end-stage liver disease patients with cirrhosis. Liver Transpl, 2017, 23(2): 155-165.
30.	Kwon HM, Moon YJ, Jung KW, et al. Neutrophil-to-lymphocyte ratio is a predictor of early graft dysfunction following living donor liver transplantation. Liver Int, 2019, 39(8): 1545-1556.
31.	Zhang Q, Raoof M, Chen Y, et al. Circulating mitochondrial DAMPs cause inflammatory responses to injury. Nature, 2010, 464(7285): 104-107.
32.	Thabut D, Massard J, Gangloff A, et al. Model for end-stage liver disease score and systemic inflammatory response are major prognostic factors in patients with cirrhosis and acute functional renal failure. Hepatology, 2007, 46(6): 1872-1882.
33.	Parker R, Armstrong MJ, Bruns T, et al. Reticulocyte count and hemoglobin concentration predict survival in candidates for liver transplantation. Transplantation, 2014, 97(4): 463-469.
34.	Badawy A, Kaido T, Hammad A, et al. The impact of preoperative hemoglobin level on the short-term outcomes after living donor liver transplantation. World J Surg, 2018, 42(12): 4081-4089.
35.	Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on sarcopenia in older people. Age Ageing, 2010, 39(4): 412-423.
36.	Kaido T, Ogawa K, Fujimoto Y, et al. Impact of sarcopenia on survival in patients undergoing living donor liver transplantation. Am J Transplant, 2013, 13(6): 1549-1556.
37.	van Vugt JLA, Alferink LJM, Buettner S, et al. A model including sarcopenia surpasses the MELD score in predicting waiting list mortality in cirrhotic liver transplant candidates: A competing risk analysis in a national cohort. J Hepatol, 2018, 68(4): 707-714.
38.	Kim YR, Park S, Han S, et al. Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria. Sci Rep, 2018, 8(1): 7157.
39.	Cheung K, Lee SS, Raman M. Prevalence and mechanisms of malnutrition in patients with advanced liver disease, and nutrition management strategies. Clin Gastroenterol Hepatol, 2012, 10(2): 117-125.
40.	Kalafateli M, Mantzoukis K, Choi Yau Y, et al. Malnutrition and sarcopenia predict post-liver transplantation outcomes independently of the Model for End-stage Liver Disease score. J Cachexia Sarcopenia Muscle, 2017, 8(1): 113-121.
41.	Cardoso NM, Silva T, Basile-Filho A, et al. A new formula as a predictive score of post-liver transplantation outcome: postoperative MELD-lactate. Transplant Proc, 2014, 46(5): 1407-1412.
42.	Huguet A, Latournerie M, Debry PH, et al. The psoas muscle transversal diameter predicts mortality in patients with cirrhosis on a waiting list for liver transplantation: A retrospective cohort study. Nutrition, 2018, 51-52: 73-79.
43.	Stam SP, Osté MCJ, Eisenga MF, et al. Posttransplant muscle mass measured by urinary creatinine excretion rate predicts long-term outcomes after liver transplantation. Am J Transplant, 2019, 19(2): 540-550.
44.	Hamaguchi Y, Kaido T, Okumura S, et al. Proposal of Muscle-MELD score, including muscularity, for prediction of mortality after living donor liver transplantation. Transplantation, 2016, 100(11): 2416-2423.

1. Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg, 1973, 60(8): 646-649.
2. Malinchoc M, Kamath PS, Gordon FD, et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology, 2000, 31(4): 864-871.
3. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology, 2001, 33(2): 464-470.
4. Wiesner R, Edwards E, Freeman R, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology, 2003, 124(1): 91-96.
5. Luo X, Leanza J, Massie AB, et al. MELD as a metric for survival benefit of liver transplantation. Am J Transplant, 2018, 18(5): 1231-1237.
6. Myers RP, Tandon P, Ney M, et al. Validation of the five-variable Model for End-stage Liver Disease (5vMELD) for prediction of mortality on the liver transplant waiting list. Liver Int, 2014, 34(8): 1176-1183.
7. Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology, 2006, 130(6): 1652-1660.
8. Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med, 2008, 359(10): 1018-1026.
9. Liver and Intestinal Organ Transplantation. Policy proposals: proposal to add serum sodium to the MELD score. http://optn.transplant.hrsa.gov/PublicComment/pubcommentPropSub. Accessed February 8, 2016.
10. Nagai S, Chau LC, Schilke RE, et al. Effects of allocating livers for transplantation based on model for end-stage liver disease-sodium scores on patient outcomes. Gastroenterology, 2018, 155(5): 1451-1462.
11. Atiemo K, Skaro A, Maddur H, et al. Mortality risk factors among patients with cirrhosis and a low model for end-stage liver disease sodium score (≤15): An analysis of liver transplant allocation policy using aggregated electronic health record data. Am J Transplant, 2017, 17(9): 2410-2419.
12. Pozo-Laderas JC, Rodríguez-Perálvarez M, Muñoz-Villanueva MC, et al. Pretransplant predictors of early mortality in adult recipients of liver transplantation in the MELD-Na Era. Med Intensiva, 2019, 43(5): 261-269.
13. Mihaylov P, Nagai S, Ekser B, et al. Prognostic impact of peritransplant serum sodium concentrations in liver transplantation. Ann Transplant, 2019, 24: 418-425.
14. Kim S, Zerillo J, Tabrizian P, et al. Postoperative Meld-lactate and isolated lactate values as outcome predictors following orthotopic liver transplantation. Shock, 2017, 48(1): 36-42.
15. Wu JF, Wu RY, Chen J, et al. Early lactate clearance as a reliable predictor of initial poor graft function after orthotopic liver transplantation. Hepatobiliary Pancreat Dis Int, 2011, 10(6): 587-592.
16. Perilli V, Aceto P, Sacco T, et al. Usefulness of postreperfusion lactate clearance for predicting early graft recovery in liver transplant patients: a single center study. Minerva Anestesiol, 2018, 84(10): 1142-1149.
17. Huh IY, Kim YK, Shin WJ, et al. Increased B-type natriuretic peptide during liver transplantation: relationship to invasively measured hemodynamic parameters. Transplant Proc, 2012, 44(5): 1318-1322.
18. Mercantini P, Di Somma S, Magrini L, et al. Preoperative brain natriuretic peptide (BNP) is a better predictor of adverse cardiac events compared to preoperative scoring system in patients who underwent abdominal surgery. World J Surg, 2012, 36(1): 24-30.
19. Toussaint A, Weiss E, Khoy-Ear L, et al. Prognostic value of preoperative brain natriuretic peptide serum levels in liver transplantation. Transplantation, 2016, 100(4): 819-824.
20. Chae MS, Koo JM, Park CS. Predictive role of tntraoperative serum brain natriuretic peptide for early allograft dysfunction in living donor liver transplantation. Ann Transplant, 2016, 21: 538-549.
21. Zhou L, Liu J, Luo F. Serum tumor markers for detection of hepatocellular carcinoma. World J Gastroenterol, 2006, 12(8): 1175-1181.
22. Fu SJ, Zhao Q, Ji F, et al. Elevated preoperative serum gamma-glutamyltranspeptidase predicts poor prognosis for hepatocellular carcinoma after liver transplantation. Sci Rep, 2016, 6: 28835.
23. 蔡尚坤, 蒋利, 杨家印. 术前血清谷氨酰胺转肽酶与肝癌患者活体肝移植术后生存的关系. 中华普通外科杂志, 2017, 32(11): 945-948.
24. Hasuike Y, Nonoguchi H, Tokuyama M, et al. Serum ferritin predicts prognosis in hemodialysis patients: the Nishinomiya study. Clin Exp Nephrol, 2010, 14(4): 349-355.
25. Weismüller TJ, Manns MP, Strassburg CP. Ferritin and liver allocation? Impact on mortality not only on the waiting list but also after orthotopic liver transplantation should be considered. Hepatology, 2010, 52(1): 392-393.
26. Weismüller TJ, Kirchner GI, Scherer MN, et al. Serum ferritin concentration and transferrin saturation before liver transplantation predict decreased long-term recipient survival. Hepatology, 2011, 54(6): 2114-2124.
27. Amulic B, Cazalet C, Hayes GL, et al. Neutrophil function: from mechanisms to disease. Annu Rev Immunol, 2012, 30: 459-489.
28. McDonald B, Urrutia R, Yipp BG, et al. Intravascular neutrophil extracellular traps capture bacteria from the bloodstream during sepsis. Cell Host Microbe, 2012, 12(3): 324-333.
29. Kalra A, Wedd JP, Bambha KM, et al. Neutrophil-to-lymphocyte ratio correlates with proinflammatory neutrophils and predicts death in low model for end-stage liver disease patients with cirrhosis. Liver Transpl, 2017, 23(2): 155-165.
30. Kwon HM, Moon YJ, Jung KW, et al. Neutrophil-to-lymphocyte ratio is a predictor of early graft dysfunction following living donor liver transplantation. Liver Int, 2019, 39(8): 1545-1556.
31. Zhang Q, Raoof M, Chen Y, et al. Circulating mitochondrial DAMPs cause inflammatory responses to injury. Nature, 2010, 464(7285): 104-107.
32. Thabut D, Massard J, Gangloff A, et al. Model for end-stage liver disease score and systemic inflammatory response are major prognostic factors in patients with cirrhosis and acute functional renal failure. Hepatology, 2007, 46(6): 1872-1882.
33. Parker R, Armstrong MJ, Bruns T, et al. Reticulocyte count and hemoglobin concentration predict survival in candidates for liver transplantation. Transplantation, 2014, 97(4): 463-469.
34. Badawy A, Kaido T, Hammad A, et al. The impact of preoperative hemoglobin level on the short-term outcomes after living donor liver transplantation. World J Surg, 2018, 42(12): 4081-4089.
35. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on sarcopenia in older people. Age Ageing, 2010, 39(4): 412-423.
36. Kaido T, Ogawa K, Fujimoto Y, et al. Impact of sarcopenia on survival in patients undergoing living donor liver transplantation. Am J Transplant, 2013, 13(6): 1549-1556.
37. van Vugt JLA, Alferink LJM, Buettner S, et al. A model including sarcopenia surpasses the MELD score in predicting waiting list mortality in cirrhotic liver transplant candidates: A competing risk analysis in a national cohort. J Hepatol, 2018, 68(4): 707-714.
38. Kim YR, Park S, Han S, et al. Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria. Sci Rep, 2018, 8(1): 7157.
39. Cheung K, Lee SS, Raman M. Prevalence and mechanisms of malnutrition in patients with advanced liver disease, and nutrition management strategies. Clin Gastroenterol Hepatol, 2012, 10(2): 117-125.
40. Kalafateli M, Mantzoukis K, Choi Yau Y, et al. Malnutrition and sarcopenia predict post-liver transplantation outcomes independently of the Model for End-stage Liver Disease score. J Cachexia Sarcopenia Muscle, 2017, 8(1): 113-121.
41. Cardoso NM, Silva T, Basile-Filho A, et al. A new formula as a predictive score of post-liver transplantation outcome: postoperative MELD-lactate. Transplant Proc, 2014, 46(5): 1407-1412.
42. Huguet A, Latournerie M, Debry PH, et al. The psoas muscle transversal diameter predicts mortality in patients with cirrhosis on a waiting list for liver transplantation: A retrospective cohort study. Nutrition, 2018, 51-52: 73-79.
43. Stam SP, Osté MCJ, Eisenga MF, et al. Posttransplant muscle mass measured by urinary creatinine excretion rate predicts long-term outcomes after liver transplantation. Am J Transplant, 2019, 19(2): 540-550.
44. Hamaguchi Y, Kaido T, Okumura S, et al. Proposal of Muscle-MELD score, including muscularity, for prediction of mortality after living donor liver transplantation. Transplantation, 2016, 100(11): 2416-2423.

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