There are also two scores using donor characteristics to predict outcome, the DRI (Donor Risk Index) developed in the USA( 9), and the derivative ET-DRI (Eurotransplant Donor Risk Index) adapted to the European donor population, which achieved a c-statistic of and 0.626 in the European population( 10). Another score using a composite of donor and recipient characteristics is the BAR (Balance of Risk) score, which is based on a sample of American and European liver transplants and achieved a c-statistic of 0.7 when predicting patient survival( 8). The SOFT (Survival Outcomes Following Liver Transplantation) Score was developed by at Columbia University to predict recipient survival after liver transplantation( 7). MELD and UKELD are primarily intended to predict waiting list mortality and therefore urgency for transplant, but perform relatively poorly at predicting survival after liver transplant( 4-6). The UKELD score was developed to risk stratify liver transplant recipients in the UK, is based on MELD and adds serum sodium( 3). The scores have been shown to predict short-term mortality after transhepatic porto-systemic shunt (TIPS) procedure, non-liver transplant surgery in cirrhotic patients, acute alcoholic hepatitis and acute variceal haemorrhage. It has also been widely used as part of clinical urgency prioritisation in liver transplant matching algorithms, although UNOS changed to the alternative MELD-Na score( 2), which incorporates serum sodium levels, in January 2016. The MELD score was originally developed at the Mayo Clinic to risk stratify elective transhepatic porto-systemic shunt (TIPS) procedures in patients with liver cirrhosis( 1).
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