Application of the Mayo primary biliary cirrhosis survival model to Mayo liver transplant patients

P. M. Grambsch, E. R. Dickson, R. H. Wiesner, A. Langworthy

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Liver transplantation is considered lifesaving for selected patients with end-stage primary biliary cirrhosis (PBC). A mathematical model to predict survival in the patient with PBC who has not undergone transplantation would be valuable for improving selection of patients for and timing of transplantation and for providing control information for assessment of the efficacy of transplantation. The Cox regression method and data from 312 Mayo Clinic patients with PBC were used to develop a model based on age, total serum bilirubin, serum albumin, prothrombin time, and severity of edema. When cross-validated on an independent set of 106 Mayo patients, the model accuarately predicted their survival. It was similar to two other published survival models in terms of risk measurement but had the advantage of not necessitating liver biopsy. The model was used to assess the efficacy of liver transplantation by comparing the Kaplan-Meier survival of 32 Mayo patients after transplantation with the average model prediction of survival without transplantation. Beyond 3 months after transplantation, Kaplan-Meier survival probabilities were significantly greater than control survival predicted by the model (P < 0.001). Examples of using the model for aiding in selection of patients for and timing of transplantation are provided.

Original languageEnglish (US)
Pages (from-to)699-704
Number of pages6
JournalMayo Clinic Proceedings
Volume64
Issue number6
StatePublished - 1989

Fingerprint

Biliary Liver Cirrhosis
Transplantation
Transplants
Survival
Liver
Liver Transplantation
Patient Selection
Prothrombin Time
Bilirubin
Serum Albumin
Edema
Theoretical Models
Biopsy
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Grambsch, P. M., Dickson, E. R., Wiesner, R. H., & Langworthy, A. (1989). Application of the Mayo primary biliary cirrhosis survival model to Mayo liver transplant patients. Mayo Clinic Proceedings, 64(6), 699-704.

Application of the Mayo primary biliary cirrhosis survival model to Mayo liver transplant patients. / Grambsch, P. M.; Dickson, E. R.; Wiesner, R. H.; Langworthy, A.

In: Mayo Clinic Proceedings, Vol. 64, No. 6, 1989, p. 699-704.

Research output: Contribution to journalArticle

Grambsch, PM, Dickson, ER, Wiesner, RH & Langworthy, A 1989, 'Application of the Mayo primary biliary cirrhosis survival model to Mayo liver transplant patients', Mayo Clinic Proceedings, vol. 64, no. 6, pp. 699-704.
Grambsch, P. M. ; Dickson, E. R. ; Wiesner, R. H. ; Langworthy, A. / Application of the Mayo primary biliary cirrhosis survival model to Mayo liver transplant patients. In: Mayo Clinic Proceedings. 1989 ; Vol. 64, No. 6. pp. 699-704.
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