VITRO score dynamics as a predictor of post-liver transplantation outcomes

Results from a single-cohort study, evaluating the prognostic value of von Willebrand factor antigen (vWF-Ag) to platelet ratio (VITRO) score dynamics on post-liver transplantation (LT) outcomes in 272 adult recipients were published in Liver Transplantation by Dominik et al. Endpoints included overall mortality and a composite endpoint of portal hypertension (PH) events and/or liver-related death within 12 months post-LT. 

Key data: In univariable analysis, post-LT VITRO score change (ΔVITRO) was associated with overall mortality (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.28–1.93; p < 0.001) and PH events/liver-related death (HR, 1.53; 95% CI, 1.24–1.88; p < 0.001) within 12 months post-LT. In multivariable analysis, ΔVITRO was as an independent predictor of mortality (adjusted HR [aHR], 1.90; 95% CI, 1.40–2.57; p < 0.001), alongside albumin (aHR, 0.89; 95% CI, 0.82–0.95; p = 0.001) and post-LT Model for End-stage Liver Disease (MELD) decrease (aHR, 0.36; 95% CI, 0.15–0.88; p = 0.026). ΔVITRO (aHR, 1.65; 95% CI, 1.32–2.05; p < 0.001) and albumin (aHR, 0.92; 95% CI, 0.86–0.99; p = 0.018) were also independent predictors of PH events/liver-related death.  

Key learning: Post-LT VITRO score dynamics independently predict mortality and PH events/liver-related death within 12 months. Integration of VITRO monitoring into routine post-LT care may support individualized risk stratification; however, further evaluation in larger multicenter cohorts is warranted.