Survival Outcomes Following Liver Transplantation (SOFT) Score: A Novel Method to Predict Patient Survival Following Liver Transplantation
Article first published online: 25 SEP 2008
© 2008 The Authors Journal compilation © 2008 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 8, Issue 12, pages 2537–2546, December 2008
How to Cite
Rana, A., Hardy, M. A., Halazun, K. J., Woodland, D. C., Ratner, L. E., Samstein, B., Guarrera, J. V., Brown Jr, R. S. and Emond, J. C. (2008), Survival Outcomes Following Liver Transplantation (SOFT) Score: A Novel Method to Predict Patient Survival Following Liver Transplantation. American Journal of Transplantation, 8: 2537–2546. doi: 10.1111/j.1600-6143.2008.02400.x
- Issue published online: 11 NOV 2008
- Article first published online: 25 SEP 2008
- Received 14 April 2008, revised 30 June 2008 and accepted for publication 30 July 2008
- Liver transplantation;
- SOFT score;
- survival outcomes following liver transplantation;
- post-transplant mortality;
- risk factors for post-transplant mortality;
- donor and recipient risk factors for death after liver transplant
It is critical to balance waitlist mortality against posttransplant mortality.
Our objective was to devise a scoring system that predicts recipient survival at 3 months following liver transplantation to complement MELD-predicted waitlist mortality.
Univariate and multivariate analysis on 21 673 liver transplant recipients identified independent recipient and donor risk factors for posttransplant mortality. A retrospective analysis conducted on 30 321 waitlisted candidates reevaluated the predictive ability of the Model for End-Stage Liver Disease (MELD) score.
We identified 13 recipient factors, 4 donor factors and 2 operative factors (warm and cold ischemia) as significant predictors of recipient mortality following liver transplantation at 3 months. The Survival Outcomes Following Liver Transplant (SOFT) Score utilized 18 risk factors (excluding warm ischemia) to successfully predict 3-month recipient survival following liver transplantation.
This analysis represents a study of waitlisted candidates and transplant recipients of liver allografts after the MELD score was implemented. Unlike MELD, the SOFT score can accurately predict 3-month survival following liver transplantation. The most significant risk factors were previous transplantation and life support pretransplant. The SOFT score can help clinicians determine in real time which candidates should be transplanted with which allografts. Combined with MELD, SOFT can better quantify survival benefit for individual transplant procedures.