Prediction of the Development of Persistent Massive Ascites after Living Donor Liver Transplantation Using a Perioperative Risk Score

Background Persistent massive ascites (PMAS) >14 days after living donor liver transplantation (LDLT) is not uncommon and associated with worse outcome. A predictive risk scoring system was constructed after analysis of recipient, graft and surgery related factors. Methods We retrospectively reviewed adult LDLT recipients from 2005 to 2011 after excluding cases that experienced any intervention for perioperative vascular-related events. Two groups were identified; PMAS and non-PMAS. The score was constructed from significant factors using weighted odds ratios (OR). Results The study population included 439 recipients. PMAS was evident in 74 cases (17%). Five significant risk predictors were identified in multivariate analysis; pretransplant serum creatinine > 1.5 mg/dl (OR: 5.693, weighted OR=2), recipient spleen to graft volume ratio > 1.3 (OR: 4.466, weighted OR=2), left lobe graft (OR: 3.196, weighted OR=1), more than 1000 mL ascites at laparotomy (OR: 2.541, weighted OR=1), and graft recipient weight ratio

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