Modified Charlson Comorbidity Index in Predicting Early Mortality After Liver Transplantation M. Wasilewicz, J. Raszeja-Wyszomirska, E. Wunsch, M. Wójcicki, and P. Milkiewicz ABSTRACT Background. The Charlson Comorbidity Index for orthotopic liver transplantation (CCI-OLT) is a modified clinical score recently proposed to be useful for the assessment of long-term survival after OLT. It includes 9 associated conditions selected upon a multivariate analysis of a large cohort of transplant recipients. Its role in predicting early mortality after OLT has not yet been investigated. We sought to CCI-OLT as a potential predictor of 1-month mortality after OLT. Materials/Methods. One hundred ninety-seven OLT were performed in our center between March 2002 and February 2009. After exclusion of patients who underwent transplantation for fulminant hepatic failure or those who underwent regrafting, we included a group of 169 patients. Viral (39%) and alcohol-induced (23%) cirrhosis were the most common indications for OLT. The CCI-OLT index was assessed in all patients. Results. In total, 146 (86%) subjects survived and 23 (14%) died within 1 month after LT. Fifty-one (30%) patients suffered at least 1 comorbidity that was included in the CCI-OLT. Direct comparison between survivor versus nonsurvivor groups showed no significant difference in terms of the total frequency of comorbidities (30.1% vs 30.4%; P  .99) or the number or the type of comorbidity. The most commonly associated condition in both groups was diabetes mellitus. Conclusion. Unlike the case of long-term survival, CCI-OLT did not seem to predict early (1-month) mortality after OLT. P REDICTION of posttransplantation survival among orthotopic liver transplantation (OLT) patients is dif- ficult. The MELD score has been initially introduced to assess mortality among patients undergoing the TIPPS (transjugular intrahepatic portosystemic shunt) procedure. Since 2002 it has been used for donor liver allocation from the transplant list in the United States and subsequently in other countries. 1 Most recently, MELD has been observed to be of excellent value to predict mortality among patients with cirrhosis undergoing various surgical procedures. However, as clearly demonstrated by Merion et al, MELD (model for end-stage liver disease) is of no use to predict the outcomes after transplantation. 2 Medical conditions, such as diabetes mellitus (DM), coronary artery disease (CAD), or chronic obstructive pulmonary disease (COPD), may exert negative effects on survival after OLT. An index called the Charlson Comorbidity Index (CCI), which has been widely used the past, includes various associated medical conditions. 3,4 It has been recently modified and adopted in the liver transplantation setting, as the Charlson Comorbidity Index—Orthotopic liver transplantation (CCI- OLT). It has been shown to be helpful to predict long-term mortality among patients undergoing OLT. 5 The aim of this study was to assess the predictive value of CCI-OLT to assess early mortality after OLT. MATERIALS AND METHODS One hundred ninety-seven OLT were performed in our institution between March 2002 and February 2009. Patients with fulminant From the Department of Hepatology and Liver Transplantation (M.W., J.R.-W., E.W., P.M.), M. Curie Hospital, Liver Unit (J.R.-W., P.M.), Pomeranian Medical School, and Department of Hepato- biliary Surgery and Liver Transplantation (M.W.), M. Curie Hos- pital, Szczecin, Poland. Address reprint requests to Piotr Milkiewicz, MD, MRCP(UK), Department of Hepatology and Liver Transplantation, M.Curie Hospital, 71-455 Szczecin, Arkonska 4, Poland. E-mail: milkiewp@ ams.edu.pl © 2009 by Elsevier Inc. All rights reserved. 0041-1345/09/$–see front matter 360 Park Avenue South, New York, NY 10010-1710 doi:10.1016/j.transproceed.2009.07.097 Transplantation Proceedings, 41, 3117–3118 (2009) 3117