Validity Of Clinical Parameters In Prediction Of Outcome For Orthotopic Liver Transplant

Background: There have been many controversies with regard to the validity of different clinical parameters in the prediction of Orthotopic Liver Transplant (OLTx) outcome. Aim: The aim was to test the validity of different clinical parameters in the prediction of the outcome of Orthotopic Liver Transplant (OLTx) at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods: A retrospective study of the different clinical parameters of 25 cases of End Stage Liver Disease (18 males and 7 females) ages from 11 to 70 years was done. These parameters were: operative duration (incision to skin closure time), highest and lowest Heart rate and Mean arterial pressure during the procedure, estimated blood lost, lowest Oxygen saturation. Biophysical outcomes were collected: lowest Platelets and Fibrinogen, highest Lactic acid, INR and Creatinine, Age of the patient and Warm ischemia time. The outcome in terms of major complications and / or death was correlated with these parameters. Receiver operating characteristic curve was applied to identify the validity of each parameter. Results: Highest INR was only parameter significantly associated with outcome of OLTx within 30 days (p = 0.044, c-index = 0.78). The value of 3.4 was the optimum cut off point giving the best validity for prediction of outcome" with 67% of sensitivity and 88% specificity " Conclusion: INR is the only predictor associated with major complication or death within 30 days post OLTx at cut of level of > 3.4