The RRI combines fourteen recipient factors at the time of transplant to summarize the post liver transplant ESRD risk into a single number. The RRI expresses the relative risk of post liver transplant ESRD for a given liver transplant recipient compared to the Reference liver transplant recipient; values exceeding 1 have higher expected ESRD risk than the Reference recipient, and vice versa.
*The baseline characteristics of reference liver transplant recipient (RRI=1.00) at liver transplantation are: Age=53-years old, African American=No, Cholestatic disease=No, Hepatitis C=No, BMI < 35 kg/m2, Diabetes=No, Serum creatinine=1.0 mg/dl, Serum albumin=2.9 g/dl, Serum bilirubin=3.5 mg/dl, Serum sodium ≥ 134 meq/l, Status-1=No, Previous liver transplant=No, TIPSS=No, Dialysis at liver transplant=No.
The RRI decile table corresponds to the predicted 1-, 3- and 5-year cumulative incidence of ESRD after liver transplantation.
Cumulative Incidence of ESRD by Decile
| Decile | RRI Range | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 |
| 1 | ≤0.58 | 0.5% | 0.7% | 0.8% | 0.9% | 1.1% | 1.4% | 1.4% | 1.4% |
| 2 | 0.59-0.81 | 0.7% | 0.8% | 1.0% | 1.3% | 1.5% | 1.6% | 1.9% | 2.6% |
| 3 | 0.82-1.00 | 0.8% | 1.1% | 1.4% | 1.7% | 2.3% | 2.6% | 3.2% | 3.4% |
| 4 | 1.01-1.22 | 0.8% | 1.1% | 1.6% | 2.1% | 2.2% | 2.9% | 3.4% | 3.7% |
| 5 | 1.23-1.48 | 1.2% | 1.7% | 2.2% | 2.7% | 3.2% | 3.7% | 4.0% | 4.2% |
| 6 | 1.49-1.83 | 1.6% | 2.2% | 2.6% | 3.5% | 4.6% | 5.3% | 6.5% | 8.4% |
| 7 | 1.84-2.35 | 1.7% | 2.4% | 3.2% | 3.7% | 4.7% | 5.8% | 6.9% | 7.8% |
| 8 | 2.36-3.24 | 2.2% | 3.3% | 4.7% | 5.9% | 6.8% | 7.9% | 9.4% | 10.1% |
| 9 | 3.25-5.21 | 4.5% | 6.0% | 7.4% | 8.9% | 10.1% | 11.2% | 12.3% | 13.0% |
| 10 | ≥5.22 | 9.7% | 12.0% | 13.9% | 16.0% | 18.0% | 19.2% | 20.1% | 20.8% |
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Reference: Sharma P, Goodrich NP, Schaubel DE, Guidinger MK, Merion RM. Patient Specific Prediction of End Stage Renal Disease Risk after Liver Transplantation. Journal of American Society of Nephrology, 2013, doi:10.1681/ASN.2013040436
Republished with permission from JASN
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Created by Asher Perlmutter and Pratima Sharma
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