Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective study

Objective: to identify predicting factors at the listing stage that could be associated with recompensation followed by patient’s delisting. Materials and methods. A prospective case-control study was conducted. The “case” cohort included 19 adult patients who initially were wait-listed as a result...

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Main Authors: V. L. Korobka, V. D. Pasechnikov, E. S. Pak, M. Y. Kostrykin, A. V. Tkachev, N. I. Balin, R. E. Gromyko, R. V. Korobka, A. M. Shapovalov, A. M. Babieva, A. B. Mikutin, V. S. Agabekyan
Format: Article
Language:Russian
Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 2020-02-01
Series:Vestnik Transplantologii i Iskusstvennyh Organov
Subjects:
Online Access:https://journal.transpl.ru/vtio/article/view/1103
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author V. L. Korobka
V. D. Pasechnikov
E. S. Pak
M. Y. Kostrykin
A. V. Tkachev
N. I. Balin
R. E. Gromyko
R. V. Korobka
A. M. Shapovalov
A. M. Babieva
A. B. Mikutin
V. S. Agabekyan
author_facet V. L. Korobka
V. D. Pasechnikov
E. S. Pak
M. Y. Kostrykin
A. V. Tkachev
N. I. Balin
R. E. Gromyko
R. V. Korobka
A. M. Shapovalov
A. M. Babieva
A. B. Mikutin
V. S. Agabekyan
author_sort V. L. Korobka
collection DOAJ
description Objective: to identify predicting factors at the listing stage that could be associated with recompensation followed by patient’s delisting. Materials and methods. A prospective case-control study was conducted. The “case” cohort included 19 adult patients who initially were wait-listed as a result of decompensated liver diseases of various origin, but later were delisted due to recompensation. The “control” cohort consisted of 61 patients who were listed during the same period for decompensation and died in the waiting list. Results. A logistic regression model was used to determine independent predictors of delisting following recompensation. Plasma albumin concentration and white blood cell count at listing became significant predictors of recompensation (p = 0.024 and p = 0.019, respectively). ROC (Receiver Operating Characteristic) curve analysis was used to compare the predictability of identified predictors. The area under the ROC curve (AUC) for plasma albumin concentration was 0.938 [95% confidence interval (CI) 0.882–0.995; p < 0.001]. The AUC for the white blood cell count was 0.924 [95% CI 0.865–0.982; p < 0.001]. The odds ratio for recompensation outcome, if the plasma albumin concentration at listing was ≥3.1 × 109/L, was 14.639 (95% CI 2.16–99.12). The odds ratio for recompensation outcome, if the plasma albumin concentration at listing was ≥39.1 g/L, was 3.06 (95% CI 1.58–5.95). Conclusion. Liver injury could be reversed after the factors leading to decompensation have ceased to exist. Independent predictors of recompensation and subsequent delisting of patients were: white blood cell count ≥3.1 × 109/L and plasma albumin concentration ≥39.1 g/L at listing for liver transplantation.
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spelling doaj.art-e821153565f9456ab7ee80934a1103b32023-03-13T10:37:26ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovVestnik Transplantologii i Iskusstvennyh Organov1995-11912020-02-01214263510.15825/1995-1191-2019-4-26-35822Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective studyV. L. Korobka0V. D. Pasechnikov1E. S. Pak2M. Y. Kostrykin3A. V. Tkachev4N. I. Balin5R. E. Gromyko6R. V. Korobka7A. M. Shapovalov8A. M. Babieva9A. B. Mikutin10V. S. Agabekyan11Rostov Regional Clinical Hospital; Rostov State Medical UniversityRostov Regional Clinical Hospital; Stavropol State Medical UniversityRostov Regional Clinical Hospital; Rostov State Medical UniversityRostov Regional Clinical HospitalRostov Regional Clinical Hospital; Rostov State Medical UniversityRostov Regional Clinical HospitalRostov Regional Clinical HospitalRostov Regional Clinical HospitalRostov Regional Clinical HospitalRostov Regional Clinical HospitalRostov Regional Clinical HospitalRostov Regional Clinical HospitalObjective: to identify predicting factors at the listing stage that could be associated with recompensation followed by patient’s delisting. Materials and methods. A prospective case-control study was conducted. The “case” cohort included 19 adult patients who initially were wait-listed as a result of decompensated liver diseases of various origin, but later were delisted due to recompensation. The “control” cohort consisted of 61 patients who were listed during the same period for decompensation and died in the waiting list. Results. A logistic regression model was used to determine independent predictors of delisting following recompensation. Plasma albumin concentration and white blood cell count at listing became significant predictors of recompensation (p = 0.024 and p = 0.019, respectively). ROC (Receiver Operating Characteristic) curve analysis was used to compare the predictability of identified predictors. The area under the ROC curve (AUC) for plasma albumin concentration was 0.938 [95% confidence interval (CI) 0.882–0.995; p < 0.001]. The AUC for the white blood cell count was 0.924 [95% CI 0.865–0.982; p < 0.001]. The odds ratio for recompensation outcome, if the plasma albumin concentration at listing was ≥3.1 × 109/L, was 14.639 (95% CI 2.16–99.12). The odds ratio for recompensation outcome, if the plasma albumin concentration at listing was ≥39.1 g/L, was 3.06 (95% CI 1.58–5.95). Conclusion. Liver injury could be reversed after the factors leading to decompensation have ceased to exist. Independent predictors of recompensation and subsequent delisting of patients were: white blood cell count ≥3.1 × 109/L and plasma albumin concentration ≥39.1 g/L at listing for liver transplantation.https://journal.transpl.ru/vtio/article/view/1103liver transplant waiting listdelisting following recompensation of liver functionpredictors of delisting
spellingShingle V. L. Korobka
V. D. Pasechnikov
E. S. Pak
M. Y. Kostrykin
A. V. Tkachev
N. I. Balin
R. E. Gromyko
R. V. Korobka
A. M. Shapovalov
A. M. Babieva
A. B. Mikutin
V. S. Agabekyan
Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective study
Vestnik Transplantologii i Iskusstvennyh Organov
liver transplant waiting list
delisting following recompensation of liver function
predictors of delisting
title Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective study
title_full Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective study
title_fullStr Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective study
title_full_unstemmed Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective study
title_short Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective study
title_sort delisting of liver transplant candidates following recompensation of chronic liver diseases patient characteristics and predictors of delisting a prospective study
topic liver transplant waiting list
delisting following recompensation of liver function
predictors of delisting
url https://journal.transpl.ru/vtio/article/view/1103
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