Predicting early outcomes of liver transplantation in young children: The EARLY study

Table 1 Univariate and multiple logistic regressions for the primary outcome of hepatic artery thrombosis after liver transplantation

Variable	Univariate logistic regression, n = 65		Multiple logistic regression, n = 65
	Odds ratio (95%CI)	P-value	Odds ratio (95%CI)	P-value
Yr	1.10 (0.89, 1.35)	0.371
Weight	0.65 (0.41, 1.04)	0.073
PELD	0.98 (0.93, 1.04)	0.514
Surgeon 2 vs 1	2.04 (0.41, 10.27)	0.388
Surgeon 3 vs 1	4.33 (0.87, 21.60)	0.074
Surgeon 2 vs 3	0.47 (0.10, 2.17)	0.334
Fascia closed on admission	3.9 (1.1, 14.3)	0.04
Hepatic artery any comment	3.9 (1.06, 14.31)	0.04
Any operating note comment1	9.82 (1.18, 81.58)	0.034
First day use of furosemide, n = 542	1.21 (1.05, 1.41)	0.011
Graft type R/SL vs WL	0.04 (0.01, 0.42)	0.006	0.06 (0.01, 0.76)	0.03
Graft type LR vs WL	0.10 (0.02, 0.48)	0.004	0.16 (0.03, 0.95)	0.044

¹No meaningful difference if we use “any operating note comment” instead of “hepatic artery any comment” in the multiple regression;

²If multiple regression is done with first day of furosemide (data available for n = 54), furosemide is significant with OR 1.67 (95%CI: 1.03, 2.73), P = 0.039, meaning the later furosemide is started the higher is the risk of HAT. CI: Confidence interval; HAT: Hepatic artery thrombosis; LR: Living related liver graft; PELD: Pediatric end-stage liver disease score; R/SL: Reduced or split liver graft; WL: Whole liver graft.

Table 2 Univariate and multiple linear regressions for the primary outcome of postoperative ventilator days after liver transplantation in n = 60 survivors

Variable	Univariate linear regression, n = 60		Multiple linear regression, n = 58
	Effect size (95%CI)	P-value	Effect size (95%CI)	P-value
Yr	-0.34 (-1.51, 0.83)	0.568
Weight	-1.36 (-3.06, 0.34)	0.114
PELD	0.03 (-0.30, 0.35)	0.866
Surgeon 2 vs 1	-0.77 (-8.69, 7.14)	0.845
Surgeon 3 vs 1	12.09 (3.15, 21.03)	0.009	10.67 (1.34, 20.01)	0.026
Surgeon 2 vs 3	-12.86 (-22.45, -3.28)	0.009	-9.69 (-19.24, -0.15)	0.047
Surgery duration, n = 541	-0.037 (-0.069, -0.005)	0.026
Fascia closed on admission	8.10 (0.52, 15.68)	0.037
Heparin started hour, n = 582	0.31 (0.17, 0.45)	0.001
Highest hemoglobin day 2-5	0.27 (0.001, 0.54)	0.049	0.22 (-0.04, 0.48)	0.096
Lowest anti-thrombin day 1, n = 44	-0.38 (-0.65, -0.11)	0.007
Lowest anti-thrombin day 2-5, n = 58	-0.35 (-0.57, -0.13)	0.003	-0.24 (-0.47, -0.02)	0.034
First day furosemide used, n = 521	1.01 (0.31, 1.70)	0.005
Graft type R/SL vs WL	-11.61 (-21.48, -1.74)	0.022	-12.53 (-21.82, -3.23)	0.009
Graft type LR vs WL	-9.27 (-18.73, 0.19)	0.055	-7.29 (-15.75, 1.17)	0.096

¹If we add “surgery duration” and “first day furosemide used” (n = 49) neither variable is significant, and if add only “first day furosemide used” also not significant;

²”Heparin started h” was not added to the multiple regression because it may be a marker of how worried the medical team are about bleeding vs thrombosis risk, and how long the INR is elevated [the correlation of “heparin started (h)” and “time for INR to be ≤ 2” is r = 0.66] (i.e., it may be an outcome, and not a determinant of outcome), and if added the effect size is 0.21 (0.07, 0.36); P = 0.005. INR: International normalized ratio; LR: Living related liver graft; PELD: Pediatric end-stage liver disease score; R/SL: Reduced or split liver graft; WL: Whole liver graft.

Table 3 Univariate and multiple logistic regression for the secondary outcome of any severe complication after liver transplantation

Variable	Univariate logistic regression, n = 65		Multiple logistic regression, n = 62
	Odds ratio (95%CI)	P-value	Odds ratio (95%CI)	P-value
Yr	0.97 (0.83, 1.14)	0.721
Weight	1.02 (0.81, 1.29)	0.857	1.44 (0.98, 2.12)	0.064
PELD	0.96 (0.92, 1.00)	0.067
Surgeon 2 vs 1	2.96 (0.92, 9.53)	0.069	10.07 (1.49, 67.87)	0.018
Surgeon 3 vs 1	6.11 (1.52, 24.50)	0.011	17.29 (1.85, 161.4)	0.012
Surgeon 2 vs 3	0.49 (0.12, 2.03)	0.322
Surgery duration, n = 59	0.995 (0.99, 1.00)	0.043
Artery vascularity	8.96 (1.03, 77.66)	0.047
Biliary anatomy comment	8.96 (1.03, 77.66)	0.047
Highest hemoglobin day 2-5	1.04 (1.00, 1.09)	0.052
Lowest anti-thrombin day 2-5, n = 62	0.95 (0.91, 0.99)	0.019	0.92 (0.86, 0.98)	0.016
First day of furosemide, n = 541	1.23 (0.99, 1.54)	0.067
Graft type LR vs WL	0.30 (0.08, 1.15)	0.079
Graft type R/SL vs WL	0.22 (0.05, 0.95)	0.042	0.06 (0.01, 0.78)	0.032

¹If multiple regression is done with first day of furosemide (n = 54), then furosemide is not significant. Surgery duration is collinear with surgeon, so only surgeon was used in the multiple regression. LR: Living related liver graft; PELD: Pediatric end-stage liver disease score; R/SL: Reduced or split liver graft; WL: Whole liver graft.

Table 4 Univariate and multiple logistic regression for the secondary outcome of any thrombosis after liver transplantation

Variable	Univariate logistic regression, n = 65		Multiple logistic regression, n = 62
	Odds ratio (95%CI)	P-value	Odds ratio (95%CI)	P-value
Yr	0.96 (0.81, 1.14)	0.656
Weight	0.74 (0.53, 1.03)	0.075
PELD	0.97 (0.93, 1.02)	0.218
Surgeon 2 vs 1	1.50 (0.37, 6.03)	0.568
Surgeon 3 vs 1	7.20 (1.75, 29.57)	0.006	8.66 (0.99, 75.63)	0.051
Surgeon 2 vs 3	0.21 (0.05, 0.88)	0.033
Surgery duration, n = 591	0.99 (0.98, 1.00)	0.017
Fascia closed on admission	2.55 (0.84, 7.78)	0.1
Hepatic artery any comment2	2.55 (0.84, 7.78)	0.1
Biliary anatomy comment2	5.12 (1.08, 24.20)	0.039
Any operating note comment	3.44 (0.99, 11.94)	0.052
Lowest anti-thrombin d2-5, n = 62	0.95 (0.91, 1.00)	0.03	0.93 (0.87, 0.99)	0.038
First day use of furosemide, n = 541	1.24 (1.04, 1.47)	0.018
Graft type R/SL vs WL	0.12 (0.03, 0.54)	0.006	0.10 (0.01, 0.85)	0.034
Graft type LR vs WL	0.10 (0.03, 0.44)	0.002	0.10 (0.01, 0.71)	0.021

¹If multiple regression is done with first day furosemide (n = 54) a trend for first day of furosemide [OR 1.37 (0.99, 1.90), P = 0.062] is found, meaning the later the furosemide is started, the higher the risk of thrombosis;

²“Any operating note comment” was used as it is collinear with “hepatic artery any comment” and “biliary anatomy comment”. If instead, we remove “any operating note comment” and add “hepatic artery any comment” and “biliary anatomy comment”, there is no meaningful change to the regression results. LR: Living related liver graft; OR: Odds ratio; PELD: Pediatric end-stage liver diseases score; R/SL: Reduced or split liver graft; WL: Whole liver graft.

Table 5 Univariate and multiple logistic regression for the posthoc secondary outcome of 6-mo first graft survival after liver transplantation

Variable	Univariate logistic regression, n = 65		Multiple logistic regression, n = 62
	Odds ratio (95%CI)	P-value	Odds ratio (95%CI)	P-value
Yr	1.08 (0.88, 1.32)	0.46
Weight	1.65 (1.01, 2.68)	0.046
PELD	1.02 (0.97, 1.07)	0.508
Surgeon 2 vs 1	0.49 (0.10, 2.47)	0.388
Surgeon 3 vs 1	0.17 (0.04, 0.84)	0.03
Surgeon 2 vs 3	2.83 (0.63, 12.71)	0.174
Fascia closed on admission	0.21 (0.06, 0.75)	0.016
Biliary atresia	0.23 (0.05, 1.14)	0.072
Surgery duration, n = 591	1.01 (1.00, 1.01)	0.097
Heparin started (h), n = 622	0.97 (0.94, 0.99)	0.019
Lowest anti-thrombin d2-5, n = 62	1.07 (1.01, 1.13)	0.018	1.08 (1.00, 1.16)	0.049
First day furosemide used, n = 541	0.88 (0.78, 0.99)	0.035
Graft type R/SL vs WL	8.31 (1.41, 49.06)	0.019	15.39 (1.01, 234.9)	0.049
Graft type LR vs WL	5.47 (1.27, 23.64)	0.023

Surgery duration and surgeon are collinear, so we could not enter both in the regression.

¹If we added “first day furosemide used” (n = 54), furosemide is not significant;

²If we added “heparin started h”, it was not significant. LR: Living related liver graft; PELD: Pediatric end-stage liver disease score; R/SL: Reduced or split liver graft; WL: Whole liver graft.