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Background: The primary goal was to calculate the value of delta Model for End-Stage Liver Disease (D-MELD) and Balance of Risk (BAR) scores in patients who underwent liver transplant. The secondary objective was to evaluate D-MELD and BAR scores' ability to predict patient and graft survival., Methods: We retrospectively evaluated 336 patients who underwent liver transplant in a tertiary medical center between January 2010 and December 2020. The D-MELD and the BAR scores were evaluated through a receiver operating characteristic curve with the calculation of area under the curve (AUC) to evaluate the predictive score power for 3-month, 6-month, 1-year, and 5-year patient and graft survivals., Results: The AUCs of D-MELD score in predicting 5-year patient and graft survival were 0.506 (95% CI, 0.43-0.57) and 0.49 (95% CI, 0.42-0.56), respectively. The AUCs of BAR score in predicting 5-year patient and graft survival were 0.50 (95% CI, 0.33-0.66) and 0.49 (95% CI, 0.30-0.67), respectively., Conclusions: We could not confirm the ability to predict long-term survival by using D-MELD and BAR scores in our sample; however, there is a statistically significant trend in receiver operating characteristic curves of 5-year patient and graft survivals. We encourage the use of new scoring systems with a greater external validation to improve allograft allocation., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: To analyze predictors of survival involved in liver retransplantation (LRT), including the Rosen Model (RM)., Materials and Methods: This was a descriptive, observational, and unicentric study based on predictors of survival including patients who underwent LRT in a tertiary medical center between April 2002 and December 2018. Recipient, donor, and transplant data were collected, and RM score was calculated for every patient. Fisher exact test and Student t test were used for qualitative and quantitative variables, respectively. The Shapiro-Wilks test was applied to verify the normality of the sample. Survival differences between subgroups were checked using the log-rank test. Statistical significance was stated at P < .05., Results: Among 32 retransplanted patients in this period, 17 (53.1%) survived more than 12 months after LRT. The results of statistical associations between prognostic factors and overall survival highlighted that an older recipient age was significantly correlated with a lower overall survival. The 3-month overall survival was 84.3%. Nineteen patients had a low risk according to RM, with a 3-month survival rate of 78.9%. Eight had a RM intermediate risk, with a survival rate of 21%. Despite the aforementioned data, the log-rank test did not find statistical differences in survival (P = .488)., Conclusion: We should consider older recipient age as a negative prognostic factor of overall survival. Also, we should contemplate intermediate risk according to RM as an adverse predictor regarding survival in LRT. Both data are of interest regarding the indication or not of LRT and prioritization on the waiting list., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Aim: To analyze the causes of liver retransplantation (LRT), which mostly depend on recipient factors., Materials and Methods: A descriptive, observational, and unicentric study including patients who underwent an LRT in a tertiary medical center between April 2002 and December 2018. Recipient, donor, and liver transplant data were collected., Results: During the period under review a total of 468 transplants were made; among them, 32 (6.8%) were LRT. The most common indication (25%) was hepatic artery thrombosis (HAT) developing ischemic cholangiopathy followed by chronic rejection (21.8%). Late LRT was performed in 71.8%. A total of 96.8% of donations were after brain death with a donor median age of 65 years. Six patients (18.7%) had HAT as a postoperative complication. The recipients' 3-, 6-, and 12-month overall survival was 72.7%, 54.6%, and 51.5%, respectively, and the 5-year was 46.8%. Leading cause of death was septic shock (42.1%)., Conclusion: In our patients, the most common cause of LRT is HAT. We had an LRT rate of 6.8%, which is consistent with national and international registers., (Copyright © 2020 Elsevier Inc. All rights reserved.)