The SOFT Cluster Score as a Multifaceted Predictive Model for Postoperative Outcomes

Authors

• Gwendolyn B Henry
• Spoorthi Kamepalli
• Carter J Burns
• Jeremy Birkmire
• George Cholankeril
• Avegail Flores
• John A Goss
• Abbas Rana

Language

English

Publication Date

6-1-2026

Journal

Transplantation Direct

DOI

10.1097/TXD.0000000000001951

PMID

42110837

PMCID

PMC13155515

PubMedCentral® Posted Date

5-6-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Consideration of both donor and recipient factors at the time of an organ offer is crucial in achieving the most optimal outcome given the shortage of available donor organs and waitlist mortality risk. Our aim was to achieve a comprehensive risk assessment for liver transplant patients by creating a series of independent risk index equations for 6 distinct posttransplant endpoints in the transplant continuum of care.

Methods: The Survival Outcomes Following Liver Transplantation (SOFT) Cluster score includes risk indices for patient mortality at 90 d, 1 y, 3 y, and 5 y posttransplant, graft failure at 1 y after transplantation, and prolonged length of stay (>30 d). Using a total sample of 61 231 patients, significant risk and protective factors were identified through univariable and multivariable analysis from a training set of 40 821 patients from the Organ Procurement and Transplantation Network database.

Results: When applied to a validation set of 20 410 patients, the SOFT Cluster score has a C-statistic of 0.66 for 90-d mortality, 0.64 for 1-y mortality, 0.63 for 3-y mortality, 0.63 for 5-y mortality, 0.76 for prolonged length of stay, and 0.60 for 1-y graft failure.

Conclusions: The SOFT Cluster score represents a novel proof-of-concept model for posttransplant risk assessment and provides physicians with a more holistic understanding of patient risk by examining a spectrum of outcomes after liver transplantation up to 5 y posttransplant using a modern cohort of recipients.

Published Open-Access

yes

Recommended Citation

Henry, Gwendolyn B; Kamepalli, Spoorthi; Burns, Carter J; et al., "The SOFT Cluster Score as a Multifaceted Predictive Model for Postoperative Outcomes" (2026). Faculty, Staff and Students Publications. 6815.
https://digitalcommons.library.tmc.edu/baylor_docs/6815