首页|Development and validation of a nomogram to predict allograft survival after pediatric liver transplantation

Development and validation of a nomogram to predict allograft survival after pediatric liver transplantation

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Background Liver transplantation is the main treatment for cholestatic liver disease and some metabolic liver diseases in children.However,no accurate prediction model to determine the survival probability of grafts prior to surgery exists.This study aimed to develop an effective prognostic model for allograft survival after pediatric liver transplantation.Methods This retrospective cohort study included 2032 patients who underwent pediatric liver transplantation between January 1,2006,and January 1,2020.A nomogram was developed using Cox regression and validated based on bootstrap sampling.Predictive and discriminatory accuracies were determined using the concordance index and visualized using calibration curves;net benefits were calculated for model comparison.An online Shiny application was developed for easy access to the model.Results Multivariable analysis demonstrated that preoperative diagnosis,recipient age,body weight,graft type,preoperative total bilirubin,interleukin-1β,portal venous blood flow direction,spleen thickness,and the presence of heart disease and cholangitis were independent factors for survival,all of which were selected in the nomogram.Calibration of the nomogram indicated that the 1-,3-,and 5-year predicted survival rates agreed with the actual survival rate.The concordance indices for graft survival at 1,3,and 5 years were 0.776,0.757,and 0.753,respectively,which were significantly higher than those of the Pediatric End-Stage Liver Disease and Child-Pugh scoring systems.The allograft dysfunction risk of a recipient could be easily predicted using the following URL:https://aspelt.shinyapps.io/ASPELT//Conclusion The allograft survival after pediatric liver transplantation(ASPELT)score model can effectively predict the graft survival rate after liver transplantation in children,providing a simple and convenient evaluation method for clinicians and patients.

Allograft survivalNomogramPediatric liver transplantation

Guang-Xiang Gu、Shu-Ting Pan、Yi-Chen Fan、Chen Chen、Qiang Xia

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Department of Liver Surgery,Renji Hospital,Shanghai Jiaotong University School of Medicine,No.160 Pujian Road,Pudong New District,Shanghai 200128,China

Department of Liver Transplantation,Sun Yet-Sen Memorial Hospital,Sun Yat-Sen University,No.107 Yanjiang West Road,Guangzhou 510080,China

Clinical Center for Investigation,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,China

Department of Anesthesiology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,China

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国家自然科学基金

81700570

2024

10.1007/s12519-023-00766-y

世界儿科杂志(英文版)

世界儿科杂志(英文版)

CSTPCD
ISSN：
年,卷(期)：2024.20(3)
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