In 1989, we reported on the efficacy of liver transplantation in @entity2835 ( @entity2835 ) by demonstrating that the actual @entity1 survival following transplantation was significantly better than without transplantation as predicted by a mathematical survival model ("Mayo natural history model"). Our aim in this investigation was to determine an optimal time to perform liver transplantation in @entity2835 . One hundred forty-three @entity1 with @entity2835 undergoing liver transplantation were followed prospectively. Disease severity was measured immediately before transplantation by a summary score ("risk score") used in the Mayo natural history model, namely age, @entity648 , albumin, prothrombin time, and the presence or absence of @entity4 . Proportional hazards analyses were performed assessing @entity1 survival following transplantation. The influence of disease severity immediately pretransplantation on resource utilization for liver transplantation was assessed. Compared with our report in 1989, liver transplantation was performed at an earlier stage of disease (e.g., median risk score: 7.5 vs. 8.3; P < .01). Following transplantation, @entity1 survival probabilities at 1, 2, and 5 years were 93%, 90%, and 88%, respectively. In the proportional hazards analysis, the risk of @entity204 following transplantation remained low until reaching a risk score of 7.8. In contrast, risk scores greater than 7.8 were associated with a progressively increased mortality. Resource utilization measured by the days in the intensive care unit (ICU) and hospital and the requirement for intraoperative blood transfusions was significantly greater in recipients who had higher risk scores before transplantation. Our data suggest that an optimal timing for liver transplantation, as determined by @entity1 survival and resource utilization, appears to be at a risk score around 7.8 in @entity1 with @entity2835 .

Optimal timing of liver transplantation for XXXX .

@entity2835 :: ('MESH:D008105', 'Disease') :: ['PBC', 'primary biliary cirrhosis'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity4 :: ('MESH:D004487', 'Disease') :: ['edema'] @entity648 :: ('MESH:D001663', 'Chemical') :: ['bilirubin'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity2835 :: (MESH:D008105,Disease) :: ['primary biliary cirrhosis']
