Prognostic model for early acute rejection after liver transplantation

Hepatic graft rejection is a common complication after liver transplantation (LT), with a maximum incidence within the first weeks, The identification of high-risk patients for early acute rejection (EAR) might be useful for clinicians. A series of 133 liver graft recipients treated with calcineurin inhibitors was retrospectively assessed to identify predisposing factors for EAR and develop a mathematica model to predict the individual risk of each patient. The incidence of EAR (less than or equal to 45 days after LT) was 35.3%. Multivariate analysis showed that recipient age, underlying liver disease, and Child's cf ass before LT were independently associated with the development of EAR. Combining these 3 variables, the following risk score for the development of EAR was obtained: EAR score EF(x)] = 2.44 + (1.14 x hepatitis C virus cirrhosis) + (2.78 x immunologic cirrhosis) + (2.51 x metabolic cirrhosis) (0.08 x recipient age in years) + (1.65 x Child's class). Risk for rejection = e(F(x))/1 + e(F(x)). The combination of age, cause of liver disease, and Child's class may allow us to predict the risk for EAR.