Survival Outcomes Following Liver Transplantation (SOFT) score: A novel method to predict patient survival following liver transplantation

A. Rana, M. A. Hardy, K. J. Halazun, D. C. Woodland, L. E. Ratner, B. Samstein, J. V. Guarrera, R. S. Brown, J. C. Emond

Research output: Contribution to journalArticlepeer-review

332 Scopus citations


It is critical to balance waitlist mortality against posttransplant mortality. Our objective was to devise a scoring system that predicts recipient survival at 3 months following liver transplantation to complement MELD-predicted waitlist mortality. Univariate and multivariate analysis on 21 673 liver transplant recipients identified independent recipient and donor risk factors for posttransplant mortality. A retrospective analysis conducted on 30 321 waitlisted candidates reevaluated the predictive ability of the Model for End-Stage Liver Disease (MELD) score. We identified 13 recipient factors, 4 donor factors and 2 operative factors (warm and cold ischemia) as significant predictors of recipient mortality following liver transplantation at 3 months. The Survival Outcomes Following Liver Transplant (SOFT) Score utilized 18 risk factors (excluding warm ischemia) to successfully predict 3-month recipient survival following liver transplantation. This analysis represents a study of waitlisted candidates and transplant recipients of liver allografts after the MELD score was implemented. Unlike MELD, the SOFT score can accurately predict 3-month survival following liver transplantation. The most significant risk factors were previous transplantation and life support pretransplant. The SOFT score can help clinicians determine in real time which candidates should be transplanted with which allografts. Combined with MELD, SOFT can better quantify survival benefit for individual transplant procedures.

Original languageEnglish (US)
Pages (from-to)2537-2546
Number of pages10
JournalAmerican Journal of Transplantation
Issue number12
StatePublished - Dec 2008
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


  • Donor and recipient risk factors for death after liver transplant
  • Liver transplantation
  • Post-transplant mortality
  • Risk factors for post-transplant mortality
  • SOFT score
  • Survival outcomes following liver transplantation


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