BAR Score Performance in Predicting Survival after Living Donor Liver Transplantation: A Single-Center Retrospective Study

Abstract

Background/Objectives. Studying the predictors of survival after liver transplantation is essential to optimize the outcome. The balance of risk (BAR) score is a predictive model which incorporates six recipient and donor factors. It showed superiority over other predictive models. We aimed to evaluate its performance in the prediction of survival after living donor liver transplantation (LDLT). Methods. 146 adult liver transplant recipients were included. Univariate and multivariate analyses were used to determine the independent predictors of survival at 3 months, 1 year, and 5 years. The receiver operating characteristic (ROC) curve for the BAR score was plotted, and the area under the ROC curve (AUROC) was calculated. Kaplan–Meier curve and log-rank test were used to compare survival above and below the best cutoff values. Results. The mean age was 52.45 ± 8.54 years, and 59.6% were males. The survival rates were 89, 78.8, and 72% at 3 months, 1 year, and 5 years, respectively. The BAR score demonstrated a clinically significant value in the prediction of 3-month (AUROC = 0.89), 1-year (AUROC = 0.76), and 5-year survival (AUROC = 0.71). Among the investigated factors associated with survival, BAR score <10 points was the only independent predictor of 3-month (OR 7.34, $p<0.0001$ ), 1-year (OR 3.37, $p=0.001$ ), and 5-year survival (OR 2.83, $p=0.044$ ). Conclusions. BAR is a simple and easily applicable scoring system that could significantly predict short- and long-term survival after LDLT. A large multicenter study is warranted to validate our results in the Egyptian population.