Seven-Up score reduces overtreatment in liver transplant patients

A new study published in Hepatobiliary & Pancreatic Diseases International suggests that a combined bio-histological approach, known as the ‘Seven-Up score’, can significantly reduce the overtreatment of early T-cell mediated rejection (TCMR) in liver transplant patients.

Research conducted at Université catholique de Louvain, led by Prof. Jan P. Lerut, analyzed 421 adult liver transplant recipients. The Seven-Up score integrates the traditional Banff histology score with a ‘Bio-score’ that tracks changes in three blood markers: total bilirubin, eosinophil count, and platelet count between post-operative days 5 and 7.

While a biopsy-only strategy would have recommended steroid treatment for 37.3% of the study group (157 patients), applying the Seven-Up score—which requires both a high Banff score and a high Bio-score—would have limited treatment to only 4.5% of patients (19 patients). This approach aims to mitigate complications from intensive immunosuppression, such as infections, kidney dysfunction, and metabolic disorders, which affect up to 40% of recipients.