ArticleEuropean radiology2022
Pre-operative CT scan helps predict outcome after liver transplantation for acute-on-chronic grade 3 liver failure.
Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Assessment of sarcopenia in cirrhosis: A practical approach using thigh and psoas ultrasound, bioimpedance, and anthropometry.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- The impact of hepatic and splenic volumetric assessment in imaging for chronic liver disease: a narrative review.Insights into imaging · 2024Review
- The novel SALT-M score predicts 1-year post-transplant mortality in patients with severe acute-on-chronic liver failure.Journal of hepatology · 2023Article
- Association between CT-Based Preoperative Sarcopenia and Outcomes in Patients That Underwent Liver Resections.Cancers · 2022Article
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11 authors.
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Abstract
objectivesThe aim of this study was to identify the prognostic value of pre-operative imaging to predict post-transplantation survival in critically ill cirrhotic patients with severe acute-on-chronic liver failure (ACLF).
methodsPatients with grade 3 ACLF who underwent liver transplantation between January 2010 and January 2020 and with available contrast-enhanced abdominal computed tomography (CT) performed less than 3 months before LT were retrospectively included (n = 82). Primary endpoint was 1-year mortality. Imaging parameters (sarcopenia, liver morphology and volumetry, and signs of portal hypertension) were screened and tested to build a prognostic score.
resultsIn the multivariate analysis, three independent CT-derived prognostic factors were found: splenomegaly (p = 0.021; HR = 5.6 (1.29-24.1)), liver atrophy (p = 0.05; HR = 2.93 (1.01-10.64)), and vena cava diameter ratio (p < 0.0001; HR = 12.7 (3.4-92)). A simple prognostic score was proposed, based on the presence of splenomegaly (5 points), liver atrophy (5 points), and vena cava diameter ratio < 0.2 (12 points). A cutoff at 10 points distinguished a high-risk group (score > 10) from a low-risk group (score ≤ 10) with 1-year survival of 27% vs. 67% respectively (p < 0.001). It was found to be an independent predictive factor in association with the Transplantation for ACLF3 Model (TAM) score.
conclusionPre-transplantation contrast-enhanced abdominal CT has a significant impact on selection of patients in ACLF3 in order to predict 1-year survival after LT. KEY POINTS: • Splenomegaly, liver atrophy, and vena cava diameter ratio are independent CT-derived prognostic factors after transplantation for severe acute-on-chronic liver failure. • A simple CT-based prognostic score is an independent predictive factor, complementary to clinical and biological parameters. • The use of the CT-derived score allows stratification based on 1-year mortality for patients with otherwise uncertain prognosis with clinical and biological parameters alone.
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