PMID- 28557956
OWN - NLM
STAT- MEDLINE
DCOM- 20170913
LR  - 20180215
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 101
IP  - 8
DP  - 2017 Aug
TI  - "Model for Early Allograft Function" Outperforms "Early Allograft Dysfunction" as
      a Predictor of Transplant Survival.
PG  - e258-e264
LID - 10.1097/TP.0000000000001833 [doi]
AB  - BACKGROUND: The Model of Early Allograft Function (MEAF) grades the severity of
      liver graft dysfunction. Unlike the categorical early allograft dysfunction (EAD)
      classification, MEAF is a continuous score, based on bilirubin, international
      normalized ratio, and alanine aminotransferase within 3 days posttransplant.
      METHODS: Multivariable regression models were used to validate the MEAF score in 
      660 liver-only transplants performed between 2000 and 2014. MEAF performance for 
      prediction of transplant survival was compared with that of EAD in univariable
      and multivariable models by means of Harrell's c-indices, integrated
      discrimination improvement, and net reclassification improvement. RESULTS: Median
      donor and recipient age was 52 years (interquartile range [IQR], 41-62 years) and
      58 years (IQR, 50-64 years), respectively. Model for End-Stage Liver Disease
      score was 15 (IQR, 11-21); cold ischemia time, 8.0 hours (IQR, 6.4-9.7 hours);
      MEAF, 4 (IQR, 3-6). EAD occurred in 182 (27.6%) cases. Transplant survival was
      93%, 90%, and 88% at 3, 6, and 12 months. Both MEAF and EAD were independent
      predictors of transplant survival within 3, 6, and 12 months. MEAF outperformed
      EAD as predictor of transplant survival, either when used as a standalone
      parameter or when corrected for additional independent predictors of transplant
      survival. CONCLUSIONS: MEAF is a more accurate predictor of transplant loss than 
      the commonly used EAD classification. As a continuous score grading graft
      dysfunction, MEAF provides additional, granulated information that could be used 
      both clinically and as a surrogate endpoint of transplant survival in clinical
      trials.
FAU - Jochmans, Ina
AU  - Jochmans I
AD  - 1 Laboratory of Abdominal Transplant Surgery, Department of Microbiology and
      Immunology, KU Leuven, Leuven, Belgium. 2 Abdominal Transplant Surgery,
      University Hospitals Leuven, Leuven, Belgium. 3 Interuniversity Centre for
      Biostatistics and Statistical Bioinformatics, Department of Public Health, KU
      Leuven, Leuven, Belgium.
FAU - Fieuws, Steffen
AU  - Fieuws S
FAU - Monbaliu, Diethard
AU  - Monbaliu D
FAU - Pirenne, Jacques
AU  - Pirenne J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
SB  - IM
MH  - Adult
MH  - Allografts
MH  - Belgium/epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Survival
MH  - Humans
MH  - Liver Transplantation/mortality
MH  - Male
MH  - Middle Aged
MH  - Primary Graft Dysfunction/diagnosis/*mortality
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Tissue Donors
EDAT- 2017/05/31 06:00
MHDA- 2017/09/14 06:00
CRDT- 2017/05/31 06:00
PHST- 2017/05/31 06:00 [pubmed]
PHST- 2017/09/14 06:00 [medline]
PHST- 2017/05/31 06:00 [entrez]
AID - 10.1097/TP.0000000000001833 [doi]
PST - ppublish
SO  - Transplantation. 2017 Aug;101(8):e258-e264. doi: 10.1097/TP.0000000000001833.