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Prognostic role of the donor risk index, the eurotransplant donor risk index and the balance of risk score on graft loss after liver transplantation

Transplant International Mar 20, 2021

Lozanovski VJ, Probst P, Arefidoust A, et al. - Researchers aimed at determining the cut‐off values for donor risk index (DRI), Eurotransplant (ET)‐DRI, and balance of risk (BAR) scores that may aid in predicting the risk of liver graft loss. Searching MEDLINE and Web of Science databases systematically and unrestrictedly. Meta‐analyses were performed to determine graft loss odds ratios and 95% confidence intervals using Mantel–Haenszel tests with a random‐effects model. Findings revealed correlation of DRI ≥ 1.4 (six studies, n = 35,580 patients) and ET‐DRI ≥ 1.4 (four studies, n = 11,666 patients) with the highest risk of graft loss at all time points. The highest risk of 3‐month and 1‐year graft loss was observed in correlation with BAR > 18 (n = 6,499 patients). Using a summary receiver operator characteristics curve, they estimated a DRI cut‐off of 1.8 and an ET‐DRI cut‐off of 1.7, however, the sensitivity and specificity of these cut‐off values were low. They suggest a negative influence of DRI and ET‐DRI score ≥ 1.4 and a BAR score > 18 on graft survival, however, these cut‐off values are not well suited for predicting graft loss.

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