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11 September 2018 : Original article  

Albumin-Bilirubin Score for Predicting Post-Transplant Complications Following Adult-to-Adult Living Donor Liver Transplantation

Wei Zhang1ABCDEF, Chang Liu1C, Yifei Tan1F, Lingcan Tan2E, Li Jiang1ACF, Jian Yang1AB, Jiayin Yang1AG*, Lunan Yan1AE, Tianfu Wen1AB

DOI: 10.12659/AOT.910824

Ann Transplant 2018; 23:639-646

Abstract

BACKGROUND: Albumin-Bilirubin (ALBI) grade has been evaluated as an objective method to assess liver function and predict postoperative complications, particularly after hepatectomy in patients with hepatocellular carcinoma (HCC). However, ALBI grade was rarely used in evaluation in living donor liver transplantation (LDLT).

MATERIAL AND METHODS: Between March 2005 and November 2015, 272 consecutive patients undergoing right-lobe LDLT were enrolled in this study. According to the ALBI score used to evaluate recipients preoperatively, those patients were divided into 3 grades (I, II, and III). Demographic findings and the post-operative complication rates were collected and compared among groups.

RESULTS: The proportions of massive blood cell transfusions were different among those 3 grades (p<0.05). The patients in grade III had a higher risk of bacterial pneumonia and early allograft dysfunction (EAD) compared to grade I (p=0.029 and p=0.038, respectively) and grade II (p=0.006 and p=0.007, respectively). The area under the receiver operating characteristic curve of ALBI, Child-Pugh, and MELD for predicting 30-day mortality were 0.702 (95% CI: 0.644–0.756), 0.669 (95% CI: 0.580–0.697, p=0.510, versus ALBI grade), and 0.540 (95% CI: 0.580–0.697, p=0.144, versus ALBI grade), respectively.

CONCLUSIONS: ALBI grade was a good index for predicting post-operative complications and had a predictive ability similar to those of the Child-Pugh classification and MELD score.

Keywords: Liver Transplantation, Living Donors, Postoperative Complications

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358