Résumé
Background: Appropriate risk stratification for the difficulty of liver transplantation (LT) is essential to guide the selection and acceptance of grafts and avoid morbidity and mortality.Methods: Based on 987 LTs collected from 5 centers, perioperative outcomes were analyzed across the 3 difficulty levels. Each LT was retrospectively scored from 0 to 10. Scores of 0-2, 3-5 and 6-10 were then translated into respective difficulty levels: low, moderate and high. Complications were reported according to the comprehensive complication index (CCI).Results: The difficulty level of LT in 524 (53%), 323 (32%), and 140 (14%) patients was classified as low, moderate and high, respectively. The values of major intraoperative outcomes, such as cold ischemia time (p=0.04) and operative time (p<0.0001) increased gradually with statistically significant values among difficulty levels. There was a corresponding increase in CCI (p=0.04), severe complication rates (p=0.05) and length of ICU (p=0.01) and hospital (p=0.004) stays across the different difficulty levels.Conclusions: The LT difficulty classification has been validated.