Publish in this journal
Journal Information
Vol. 43. Issue 5.
Pages 261-269 (June - July 2019)
Download PDF
More article options
Vol. 43. Issue 5.
Pages 261-269 (June - July 2019)
DOI: 10.1016/j.medine.2019.04.004
Pretransplant predictors of early mortality in adult recipients of liver transplantation in the MELD-Na Era
Predictores pretrasplante de mortalidad precoz en receptores adultos de trasplante hepático en la era MELD-Na
J.C. Pozo-Laderasa,b,
Corresponding author

Corresponding author.
, M. Rodríguez-Perálvarezc,b, M.C. Muñoz-Villanuevad, F. Rivera-Espinara, I. Durban-Garcíaa, J. Muñoz-Trujilloa, J.C. Robles-Aristaa,b, J. Briceño-Delgadoe,b
a UCG Medicina Intensiva, Hospital Universitario Reina Sofía, Córdoba, Spain
b Instituto Maimónides de Investigación Biomédica IMIBIC, Córdoba, Spain
c UGC Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, Spain
d Unidad de Bioestadística Médica, Instituto Maimónides de Investigación Biomédica IMIBIC, Córdoba, Spain
e UGC Cirugía General, Hospital Universitario Reina Sofía, Córdoba, Spain
This item has received
Article information
Full Text
Download PDF
Figures (2)
Tables (4)
Table 1. Description of the pretransplantation characteristics of the cohort of liver transplant recipients and cases–controls (N=471).
Table 2. Evaluation of the pretransplantation predictors of early mortality after liver transplant. Bivariate analysis (N=471).
Table 3. Independent pretransplantation predictors of early mortality after liver transplant. Multivariate logistic regression analysis. Final models.
Table 4. Comparison of ROC using the DeLong test.
Show moreShow less

To identify pretransplant predictors of early mortality (90 days after transplantation) and evaluate their discriminating capacity in adult liver transplant recipients (LTRs).


An observational, retrospective, nested cases–controls study from a consecutive cohort of LTRs was carried out.


University hospital.


All consecutive LTR between January 2003 and December 2016 were eligible for inclusion. Patients with acute liver failure, previous graft dysfunction, simultaneous multiple organ transplantation, non-heart beating donors, and those needing urgent retransplantation during the study period were excluded. The analysis comprised 471 patients.

Main variables of interest

Pretransplant characteristics were the main variables of interest. The LTR were grouped according to the dependent variable (early mortality). Multivariate logistic regression analysis was conducted to identify predictors of early mortality. The discriminating capacity of the models obtained was evaluated by comparing ROC curves (models versus MELD-Na).


The MELD-Na score (OR=1.069, 95% CI=1.014–1.127), age >60 years (OR=2.479, 95% CI=1.226–5.015), and LTR height <163cm (OR=4.092, 95% CI=2.115–7.917) were identified as independent predictors of early mortality. The cause of transplantation (hepatocellular carcinoma or decompensated cirrhosis) was identified as a confounding factor.


In LTR due to decompensated cirrhosis, the MELD-Na score, age >60 years, and height <163cm are independent predictors of early mortality. These factors provide a better classification model than the MELD-Na score for early post-transplant mortality.

Liver transplantation
Early postoperative mortality
Pretransplant risk factors

Identificar predictores pretrasplante de mortalidad precoz (90 días postrasplante) y evaluar su capacidad discriminante en receptores adultos de trasplante hepático (RTH).


Estudio observacional, retrospectivo, de casos y controles anidados sobre una cohorte consecutiva de RTH.


Hospital Universitario.


Desde enero de 2003 a diciembre de 2016, todos los receptores adultos de trasplante hepático fueron elegibles para inclusión. Fueron excluidos los RTH por fallo hepático agudo, disfunción de un injerto previo, trasplante simultáneo de órganos, de donantes en asistolia, y aquellos que precisaron retrasplante durante el periodo de estudio. Para el análisis se incluyeron 471 pacientes.

Principales variables de interés

Las características pretrasplante fueron las variables de interés. Los RTH fueron agrupados de acuerdo con la variable dependiente (mortalidad precoz). Los predictores se obtuvieron mediante análisis multivariante de regresión logística. La capacidad discriminante de los modelos obtenidos se evaluó mediante comparación de curvas ROC.


Se identificaron como predictores independientes de mortalidad precoz: la puntuación MELD-Na (OR=1,069; IC95%=1,014-1,127), la edad mayor de 60 años (OR=2,479; IC95%=1,226-5,015), y la estatura del RTH inferior a 163cm (OR=4,092; IC95%=2,115-7,917), considerándose el motivo del trasplante (carcinoma hepatocelular o cirrosis descompensada) como variable de confusión.


En los RTH por cirrosis descompensada, la puntuación MELD-Na, la edad mayor de 60 años y la estatura del receptor inferior a 163cm son predictores independientes de mortalidad precoz. Esos predictores producen un modelo que clasifica a los pacientes significativamente mejor que el MELD-Na en relación con la mortalidad precoz.

Palabras clave:
Trasplante hepático
Mortalidad precoz
Factores pretrasplante


These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC ( )and click the link to the magazine.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe to

Medicina Intensiva (English Edition)

Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Medicina Intensiva (English Edition)

Subscribe to our newsletter

Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.