Detailed Abstract
[E-poster - Liver (Transplantation)]
[EP 033] Validation of Sundaram ACLF-LT-Mortality (SALT-M) Score in Korean Patients with Acute-on-Chronic Liver Failure
Deok-Gie KIM 1, Seung Hyuk YIM 1, Eun-Ki MIN 1, Mun Chae CHOI 1, Hwa-Hee KOH 1, Minyu KANG 1, Young Jin YOO 1, Jae Geun LEE 1, Dong Jin JOO 1, Myoung Soo KIM 1
1 Surgery, Severance Hospital, REPUBLIC OF KOREA
Background : Recently, SALT-M score has been developed for predicting 1-year post-liver transplantation mortality in patients with severe Acute-on-Chronic Liver Failure (ACLF). We validated the SALT-M score in Asian large-volume single center cohort.
Methods : We analyzed 224 patients with ACLF grade 2 or 3. Area under the receiver operating characteristic curve (AUROC) and concordance index (c-index) were used to assess and compare the predictability for post-transplant mortality between SALT-M and other scores. Moreover, we compared the survival between patients with high SALT-M and low SALT-M, in patients categorized by MELD score or ACLF grade.
Results : The AUROC for predicting 1-year post-LT survival was higher in SALT-M (0.691) compared to MELD, MELD-Na, MELD 3.0, and delta MELD. Similarly, c-index of the SALT-M (0.650) was also higher than aforementioned MELD systems. When categorized by the cutoff for SALT-M (≥20) and MELD (≥30), patients with high SALT-M showed lower post-LT survival than those with low SALT-M regardless of high or low MELD (40.0% for high SALT-M/high MELD vs. 42.9% for high SALT-M/low MELD vs. 73.8% for low SALT-M/high MELD vs. 63.7% for low SALT-M/low MELD, p<0.001). In subgroup only with ACLF grade 3, post-transplant mortality was also effectively stratified by the SALT-M score (39.4% for high SALT-M vs. 63.1% for low SALT-M, p=0.02).
Conclusions : SALT-M outperformed previous MELD systems for post-transplant mortality in Asian LT cohort with severe ACLF, which showed lower BMI and higher LDLT rate. Transplantability for the patients with severe ACLF could be determined based on SALT-M.
Methods : We analyzed 224 patients with ACLF grade 2 or 3. Area under the receiver operating characteristic curve (AUROC) and concordance index (c-index) were used to assess and compare the predictability for post-transplant mortality between SALT-M and other scores. Moreover, we compared the survival between patients with high SALT-M and low SALT-M, in patients categorized by MELD score or ACLF grade.
Results : The AUROC for predicting 1-year post-LT survival was higher in SALT-M (0.691) compared to MELD, MELD-Na, MELD 3.0, and delta MELD. Similarly, c-index of the SALT-M (0.650) was also higher than aforementioned MELD systems. When categorized by the cutoff for SALT-M (≥20) and MELD (≥30), patients with high SALT-M showed lower post-LT survival than those with low SALT-M regardless of high or low MELD (40.0% for high SALT-M/high MELD vs. 42.9% for high SALT-M/low MELD vs. 73.8% for low SALT-M/high MELD vs. 63.7% for low SALT-M/low MELD, p<0.001). In subgroup only with ACLF grade 3, post-transplant mortality was also effectively stratified by the SALT-M score (39.4% for high SALT-M vs. 63.1% for low SALT-M, p=0.02).
Conclusions : SALT-M outperformed previous MELD systems for post-transplant mortality in Asian LT cohort with severe ACLF, which showed lower BMI and higher LDLT rate. Transplantability for the patients with severe ACLF could be determined based on SALT-M.
SESSION
E-poster
E-Session 03/21 ALL DAY