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Objective To evaluate the predictive values of albumin-bilirubin (ALBI) and easy albumin-bilirubin (EZ-ALBI) scores for early survival (postoperative 3 months) of recipients with liver failure after liver transplantation. Methods Clinical data of 137 recipients diagnosed with liver failure and underwent liver transplantation were retrospectively analyzed. The optimal cut-off values of preoperative ALBI, EZ-ALBI and MELD scores to predict early survival of recipients with liver failure after liver transplantation were determined by the area under the receiver operating characteristic (ROC) curve. The risk factors of early death of recipients with liver failure after liver transplantation were identified by univariate and multivariate Cox regression analyses. The effects of different ALBI and EZ-ALBI levels upon early prognosis of recipients with liver failure after liver transplantation were analyzed. Results The optimal cut-off values of ALBI, EZ-ALBI and MELD scores were 0.21, -19.83 and 24.36, and the AUC was 0.706, 0.697 and 0.686, respectively. Univariate Cox regression analysis showed that preoperative alanine aminotransferase(ALT)≥50 U/L, aspartate aminotransferase(AST)≥60 U/L, ALBI score≥0.21 and EZ-ALBI score≥-19.83 were the risk factors for early postoperative death of recipients with liver failure after liver transplantation (all P < 0.05). Multivariate Cox regression analysis demonstrated that preoperative ALBI score≥0.21 was an independent risk factor for early postoperative death of recipients with liver failure after liver transplantation (P < 0.05). According to the optimal cut-off value of ALBI score, the early survival rates in the ALBI < 0.21 (n=46) and ALBI≥0.21(n=91) groups were 93.5% and 64.8%, and the difference was statistically significant (P < 0.05). According to the optimal cut-off value of EZ-ALBI score, the early survival rates in the EZ-ALBI < -19.83(n=60) and EZ-ALBI≥-19.83(n=77) groups were 88.3% and 63.6%, and the difference was statistically significant (P < 0.05). Conclusions Preoperative ALBI score is of high predictive value for early survival of recipients with liver failure after liver transplantation, which could be utilized as a reference parameter for selecting liver transplant recipients.
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Objective:To explore the predictive value of platelet-albumin-bilirubin(PALBI)score for tumor recurrence after liver transplantation(LT)in patients with hepatocellular carcinoma(HCC).Methods:Clinical data were retrospectively reviewed for 102 HCC patients undergoing LT from January 2010 to December 2020.The predictive value of PALBI score for tumor recurrence after LT and the risk factors for tumor recurrence after LT were examined by receiver operating characteristic(ROC)curve, Kaplan-Meier method and univariate/multivariate Cox regression.Results:The optimal cutoff value of preoperative PALBI score for predicting recurrence was -3.82 with ROC curve, Youden's index 0.317 and area under the ROC curve 0.679.Survival analysis was performed using a PALBI cutoff value of -3.82 as boundary group.The results showed that significant differences existed in 1/3/5-year tumor recurrence rates(17.9% vs.50.0%, 26.9% vs.62.5%, 29.5% vs.62.5%)after low PALBI and high PALBI( P<0.05 for all). Univariate analysis indicated that preoperative tumor maximal diameter, tumor number, Milan criteria, alpha fetoprotein(AFP)level, microvascular invasion, portal venous tumor thrombus, and PALBI score were significantly associated with postoperative tumor recurrence( P<0.05 for all). And multivariate analysis revealed that Milan criteria, AFP level and PALBI score were independent risk factors for postoperative tumor recurrence( P<0.05). Conclusions:Preoperative PALBI score offers some predictive value for postoperative tumor recurrence in HCC patients post-LT.When preoperative PALBI score ≥-3.82 in HCC patients, postoperative tumor recurrence rate is relatively high.