Survival outcomes scores (SOFT,BAR, and Pedi‐SOFT) are accurate in predicting post‐liver transplant survival in adolescents

Abstract

SOFT and BAR scores utilize recipient, donor, and graft factors to predict the 3-month survival after LT in adults (≥18 years). Recently, Pedi-SOFT score was developed to predict 3-month survival after LT in young children (≤12 years). These scoring systems have not been studied in adolescent patients (13-17 years). We evaluated the accuracy of these scoring systems in predicting the 3-month post-LT survival in adolescents through a retrospective analysis of data from UNOS of patients aged 13-17 years who received LT between 03/01/2002 and 12/31/2012. Recipients of combined organ transplants, donation after cardiac death, or living donor graft were excluded. A total of 711 adolescent LT recipients were included with a mean age of 15.2±1.4 years. A total of 100 patients died post-LT including 33 within 3 months. SOFT, BAR, and Pedi-SOFT scores were all found to be good predictors of 3-month post-transplant survival outcome with areas under the ROC curve of 0.81, 0.80, and 0.81, respectively. All three scores provided good accuracy for predicting 3-month survival post-LT in adolescents and may help clinical decision making to optimize survival rate and organ utilization.

Potential value and limitations of different clinical scoring systems in the assessment of short- and long-term outcome following orthotopic liver transplantation

“…This is in line with the findings of Schlegel et al who reported a related c-statistic of 0.754 for severe complications (CD≥3b) and 0.734 for 90-day mortality in case of the BAR-score [18]. The robust nature of the BAR score in predicting outcomes has been confirmed in other cohorts including pediatric/adolescent patients as well as in recipients of living donor liver transplantation [33, 34].…”

Predictive Capacity of Risk Models in Liver Transplantation

“…In one study, a c-index of 0.8 was reported for both the BAR and SOFT scores. 26 The D-MELD was also developed for patient survival. It has a relatively low reported predictive capacity, most likely because of its simplicity and because it is often applied to short-term outcomes.…”

The BAR Score Predicts and Stratifies Outcomes Following Liver Retransplantation: Insights From a Retrospective Cohort Study

“…The BAR score fulfils all these criteria. Among risk scores which are based on data available at the time of organ acceptance, the BAR score performs best and its robustness in predicting post-transplant outcomes in various settings has been shown in multiple studies including ours [36][37][38].…”