The measurement of surgical outcomes, especially in cardiac surgery, has been extensively researched.1 In liver transplantation, several models have been used to identify factors associated with outcomes. [2][3][4][5][6] However, most models are based on data from a single centre; thus their results cannot confidently be extrapolated to other populations of individuals receiving transplants. Furthermore, the models are restricted to an assessment of survival at 12 months after transplantation. Although mortality at 12 months reflects surgical mortality, it also captures mortality associated with recurrent disease, chronic rejection, and retransplantation. Mortality rates at timepoints earlier than 12 months predominantly include surgical mortality, however, and could be associated with different factors to those linked to mortality at 1 year.Data from the European Liver Transplant Registry (ELTR) have been used to establish the intrinsic mortality risk associated with liver transplantation without identified risk factors;8 the results of the study by Adam and colleagues suggest that every centre could assess its own performance by combining this risk with the quoted relative risk ratios of known risk factors. However, the approach used to estimate the risk ratios (proportional hazards regression) does not provide absolute expected mortality rates, thereby limiting the practical application of these results. Furthermore, the results were based on transplants undertaken up to December, 1997. As survival continues to improve after liver transplantation, these models need to be updated. Our aim, therefore, was to assess 3-month and 12-month mortality after first liver transplantation in a cohort of adult recipients from the ELTR who had transplants up to 2003. Methods PopulationThe ELTR database contains information about all liver transplants done in 23 European countries since 1968. 9The methods used to obtain the data and details of the data collected have been described previously, 8 and SummaryBackground Mortality after liver transplantation depends on heterogeneous recipient and donor factors. Our aim was to assess risk of death and to develop models to help predict mortality after liver transplantation.

Over the last 15 years, various oncology groups throughout the world have used the PRETEXT system for staging malignant primary liver tumours of childhood. This paper, written by members of the radiology and surgery committees of the International Childhood Liver Tumor Strategy Group (SIOPEL), presents various clarifications and revisions to the original PRETEXT system.

In EBV-infected pediatric liver transplant recipients, use of OKT3 or antithymocyte globulin and high tacrolimus blood levels are risk factors for a significant increase in the incidence of PTLD. An increase in total gamma-globulin level and appearance of mono/oligoclonal immunoglobulin production are the major preliminary signs of the syndrome.

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