TY - JOUR
T1 - Adaptation of the Mayo primary biliary cirrhosis natural history model for application in liver transplant candidates
AU - Kim, W. Ray
AU - Wiesner, Russell H.
AU - Poterucha, John J.
AU - Therneau, Terry M.
AU - Benson, Joanne T.
AU - Krom, Ruud A.F.
AU - Dickson, E. Rolland
N1 - Funding Information:
From the Mayo Clinic and Foundation, Rochester, MN. Supported by a grant from the National Institutes of Health (DK-34238). Address reprint requests to W. Ray Kim, MD, Division of Gastroenterology and Hepatology, Mayo Clinic (W19), 200 First St SW, Rochester, MN 55905. Telephone: 507-284-2505; FAX: 507-284-0538; E-mail: kim.woong@mayo.edu Copyright r 2000 by the American Liver Diseases 1527-6465/00/0604-0117$3.00/0 doi:10.1053/jlts.2000.6503
PY - 2000
Y1 - 2000
N2 - The Mayo natural history model has been used widely as a tool to estimate prognosis in patients with primary biliary cirrhosis (PBC), particularly liver transplant candidates. We present an abbreviated model in which a tabular method is used to approximate the risk score, which may be incorporated in the minimal listing criteria for liver transplant candidates. Data used in the development and validation of the original Mayo model were derived from 418 patients with well-characterized PBC. To construct an abbreviated risk score in a format similar to that of Child-Turcotte-Pugh score, 1 to 3 cut-off criteria were determined for each variable, namely age (0 point for <38, 1 for 38 to 62 and 2 for ≥63 years), bilirubin (0 point for < 1, 1 for 1 to 1.7, 2 for 1.7 to 6.4, and 3 for >6.4 mg/dL), albumin (0 point for >4.1, 1 for 2.8 to 4.1, and 2 for <2.8 g/dL), prothrombin time (1 point for normal and 2 for prolonged) and edema (0 point for absent and 1 for present). The intervals between these criteria were chosen in a way to enable a meaningful classification of patients according to their risk for death. This score is highly correlated with the original risk score (r = 0.93; P < .01). The Kaplan-Meier estimate at 1 year was 90.6% in patients with a score of 6. The abbreviated risk score is a convenient method to quickly estimate the risk score in patients with PBC. An abbreviated score of 6 may be consistent with the current minimal listing criteria in liver transplant candidates.
AB - The Mayo natural history model has been used widely as a tool to estimate prognosis in patients with primary biliary cirrhosis (PBC), particularly liver transplant candidates. We present an abbreviated model in which a tabular method is used to approximate the risk score, which may be incorporated in the minimal listing criteria for liver transplant candidates. Data used in the development and validation of the original Mayo model were derived from 418 patients with well-characterized PBC. To construct an abbreviated risk score in a format similar to that of Child-Turcotte-Pugh score, 1 to 3 cut-off criteria were determined for each variable, namely age (0 point for <38, 1 for 38 to 62 and 2 for ≥63 years), bilirubin (0 point for < 1, 1 for 1 to 1.7, 2 for 1.7 to 6.4, and 3 for >6.4 mg/dL), albumin (0 point for >4.1, 1 for 2.8 to 4.1, and 2 for <2.8 g/dL), prothrombin time (1 point for normal and 2 for prolonged) and edema (0 point for absent and 1 for present). The intervals between these criteria were chosen in a way to enable a meaningful classification of patients according to their risk for death. This score is highly correlated with the original risk score (r = 0.93; P < .01). The Kaplan-Meier estimate at 1 year was 90.6% in patients with a score of 6. The abbreviated risk score is a convenient method to quickly estimate the risk score in patients with PBC. An abbreviated score of 6 may be consistent with the current minimal listing criteria in liver transplant candidates.
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U2 - 10.1053/jlts.2000.6503
DO - 10.1053/jlts.2000.6503
M3 - Article
C2 - 10915173
AN - SCOPUS:0033929192
SN - 1527-6465
VL - 6
SP - 489
EP - 494
JO - Liver Transplantation
JF - Liver Transplantation
IS - 4
ER -