Evidence mapPaperPMID 41640957Full record

ArticleWorld journal of hepatology2026

Application of modified Charlson comorbidity index for predicting outcomes following adult living donor liver transplantation.

Gowtham Rajan, Amal Francis Sam, Akila Rajakumar, Dinesh Jothimani, Mohamed Rela

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Article in World journal of hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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3 · Its place in the literature

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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Gowtham RajanDepartment of Liver Anaesthesiology and Critical Care, Dr. Rela Institute, Chennai 600044, Tamil Nadu, India.
Amal Francis SamDepartment of Liver Anaesthesiology and Critical Care, Institute of Liver Disease and Transplantation, Chennai 600044, Tamil Nadu, India.
Akila RajakumarDepartment of Liver Transplant Anaesthesia and Intensive Care, Institute of Liver Disease and Transplantation, Dr. Rela Institute, Chennai 600044, Tamil Nadu, India. drakila.rajakumar@gmail.com.
Dinesh JothimaniDepartment of Hepatology, Dr. Rela Institute, Chennai 600044, Tamil Nadu, India.
Mohamed RelaInstitute of Liver Disease and Transplantation, Dr. Rela Institute and Medical Centre, Chennai 600044, Tamil Nadu, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe model for end-stage liver disease (MELD) score helps assess the severity of liver disease and can predict survival after liver transplant. The Charlson comorbidity index (CCI) is frequently employed to forecast the 10-year survival probability of patients with multiple health conditions. We employed the CCI to evaluate the impact of comorbid health conditions on patients and assess its predictive capability regarding health complications and mortality following living donor liver transplantation (LDLT).

aimTo understand the prevalence of extrahepatic comorbidities in our cohort of LDLT patients with modified CCI (mCCI) and to analyze the utility of mCCI as a predictor of morbidity and mortality following LDLT.

methodsAfter obtaining institutional ethics committee approval, a retrospective analysis was conducted on 497 adult patients who underwent LDLT at our institute between January 2021 and December 2023.

resultsOur analysis revealed that the area under the curve (AUC) of the original CCI for predicting 90-day mortality decreased when malignancy was assigned a score of 2 in patients with hepatocellular carcinoma undergoing transplantation. Therefore, we used a mCCI. Both MELD and mCCI scores demonstrated predictive value for 90-day mortality, with AUCs of 0.60 and 0.62, respectively. Using regression coefficients, we developed a composite score defined as: Combined score = [mCCI + (MELD/10)]. This composite metric improved predictive accuracy, yielding an AUC of 0.70 for 90-day mortality prediction. Patients with a CCI > 3 and a MELD > 21 had a significantly higher 90-day mortality rate than others (12.5%

conclusionThe mCCI was independent of decompensation and overall disease severity. Combining MELD and CCI scores enhanced the discriminatory power for predicting morbidity and 90-day mortality.

Indexed as

Charlson comorbidity indexCharlson comorbidity index vs model for end-stage liver diseaseComposite outcome scores in living donor liver transplantationModified Charlson comorbidity index in liver transplantationOutcome prediction in living donor liver transplantationPost living donor liver transplantation outcomes

Identifiers

PMID41640957
PMCPMC12865464

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