Pre-transplant ALBI Grade 3 Is Associated with Increased Mortality After Liver Transplantation

BackgroundAlthough MELD score is a reliable tool for estimating mortality in the waiting list, criteria for preoperative prediction of survival after liver transplantation (LT) are lacking. ALBI score was validated as a prognostic marker for hepatocellular carcinoma patients undergoing transarterial chemoembolization, hepatic resection, and sorafenib treatment but not for LT outcomes yet. This study aimed to evaluate ALBI score as a prognostic factor in LT.MethodsThisis a single-center analysis of patients undergoing LT between October 2001 and June 2017. Primary endpoint was overall post-LT mortality. Secondary endpoint was 90-day mortality.ResultsOf all 301 patients included in this study, 185 (61.5%) were males. Themedian age was 54.111.3years. Univariate and multivariate analysis revealed that ALBI grade 3 (HR 1.836, 95% CI 1.154-2.921, p=0.010), low serum albumin (HR 0.628, 95% CI 0.441-0.893, p=0.010), black race (HR 2.431, 95% CI 1.160-5.092, p=0.019), and elevated body mass index (HR 1.061, 95% CI 1.022-1.102, p=0.002) all were associated with decreased overall survival following LT. Patients with both ALBI grade 3 (n=25) and calculated MELD score25 had the lowest overall survival (p<0.001).Discussion p id=Par4 ALBI grade 3 was related to lower post-LT survival and can be utilized as a tool for risk stratification in LT.