Delisting of liver transplant candidates following recompensation of chronic liver diseases – patient characteristics and predictors of delisting: a prospective study

Abstract

Objective: to identify predicting factors at the listing stage that could be associated with recompensation followed by patient’s delisting. Materials and methods. A prospective case-control study was conducted. The “case” cohort included 19 adult patients who initially were wait-listed as a result of decompensated liver diseases of various origin, but later were delisted due to recompensation. The “control” cohort consisted of 61 patients who were listed during the same period for decompensation and died in the waiting list. Results. A logistic regression model was used to determine independent predictors of delisting following recompensation. Plasma albumin concentration and white blood cell count at listing became significant predictors of recompensation (p = 0.024 and p = 0.019, respectively). ROC (Receiver Operating Characteristic) curve analysis was used to compare the predictability of identified predictors. The area under the ROC curve (AUC) for plasma albumin concentration was 0.938 [95% confidence interval (CI) 0.882–0.995; p < 0.001]. The AUC for the white blood cell count was 0.924 [95% CI 0.865–0.982; p < 0.001]. The odds ratio for recompensation outcome, if the plasma albumin concentration at listing was ≥3.1 × 109/L, was 14.639 (95% CI 2.16–99.12). The odds ratio for recompensation outcome, if the plasma albumin concentration at listing was ≥39.1 g/L, was 3.06 (95% CI 1.58–5.95). Conclusion. Liver injury could be reversed after the factors leading to decompensation have ceased to exist. Independent predictors of recompensation and subsequent delisting of patients were: white blood cell count ≥3.1 × 109/L and plasma albumin concentration ≥39.1 g/L at listing for liver transplantation.

Keywords

• liver transplant waiting list
• delisting following recompensation of liver function
• predictors of delisting