Work

Refining the Liver Donor Risk Index With Machine Perfusion: A Bayesian Approach

Year: 2025

Type: article

Abstract: INTRODUCTION: The Donor Risk Index (DRI) is a widely used liver transplant allograft risk model but does not account for the increasing adoption of machine perfusion (MP). METHODS: Using Bayesian updating, we incorporated MP into the DRI framework (DRI-MP). A Bayesian proportional hazards model with informative priors derived from the original DRI was applied to Organ Procurement and Transplantation Network data from January 2022 to June 2024. Model performance was assessed using Harrell Concordance-statistic, calibration plots, and Brier scores. RESULTS: DRI-MP, defined as DRI × 0.7 for MP cases, improved 90-day graft survival discrimination (Harrell Concordance-statistic: = 0.546 vs 0.535, P = 0.040), while maintaining robust calibration. DISCUSSION: The Bayesian-updated DRI-MP modestly improves donor risk discrimination, reflecting contemporary transplant practice and providing an implementable tool with continuity from the original DRI.

Source: Clinical and Translational Gastroenterology

DOI: 10.14309/ctg.0000000000000921

Authors: Tomohiro Tanaka, Daniel Sewell

Institution: University of Iowa

Language: English

Topic: Organ Transplantation Techniques and Outcomes

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,800