Wu et al reported a perioperative risk score for predicting persistent massive ascites after living donor liver transplantation. The authors are from Chang Gung Memorial Hospital in Kaohsiung. Taiwan.
PMAS = preoperative massive ascites score
Patient selection: living donor liver transplant recipient
Outcome: persistent massive ascites (persistent ascites, > 1,000 mL collected from abdominal drains, present after post-operative day 14
Parameters:
(1) pretransplant serum creatinine in mg/dL
(2) ratio of spleen volume to graft volume (SGR)
(3) graft side (donor lobe) grafted
(4) preoperative ascites in mL
(5) graft/recipient weight ratio (GRWR)
|
Parameter
|
Finding
|
Points
|
|
serum creatinine
|
<= 1.5 mg/dL
|
0
|
|
|
> 1.5 mg/dL
|
2
|
|
ratio of spleen to graft
|
<= 1.3
|
0
|
|
|
> 1.3
|
2
|
|
graft side
|
left
|
1
|
|
|
right
|
0
|
|
ascites volume
|
<= 1,000 mL
|
0
|
|
|
> 1,000 mL
|
1
|
|
GRWR
|
< 0.8%
|
1
|
|
|
>= 0.8%
|
0
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the risk of persistent ascites.
• Patients who did not develop persistent ascites had a mean score of 1 (range 0 to 2).
• A score less than 3 was seen in 53% of patients who developed persistent ascites.
Performance:
• The reported area under the ROC curve is 0.78.
