Predicting Short-term Survival after Liver Transplantation using Machine Learning

Sci Rep. 2020 Mar 27;10(1):5654. doi: 10.1038/s41598-020-62387-z.

Abstract

Liver transplantation is one of the most effective treatments for end-stage liver disease, but the demand for livers is much higher than the available donor livers. Model for End-stage Liver Disease (MELD) score is a commonly used approach to prioritize patients, but previous studies have indicated that MELD score may fail to predict well for the postoperative patients. This work proposes to use data-driven approach to devise a predictive model to predict postoperative survival within 30 days based on patient's preoperative physiological measurement values. We use random forest (RF) to select important features, including clinically used features and new features discovered from physiological measurement values. Moreover, we propose a new imputation method to deal with the problem of missing values and the results show that it outperforms the other alternatives. In the predictive model, we use patients' blood test data within 1-9 days before surgery to construct the model to predict postoperative patients' survival. The experimental results on a real data set indicate that RF outperforms the other alternatives. The experimental results on the temporal validation set show that our proposed model achieves area under the curve (AUC) of 0.771 and specificity of 0.815, showing superior discrimination power in predicting postoperative survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Area Under Curve
  • End Stage Liver Disease / mortality
  • End Stage Liver Disease / surgery
  • Female
  • Graft Survival / physiology*
  • Humans
  • Liver / surgery*
  • Liver Function Tests / methods
  • Liver Transplantation / mortality*
  • Machine Learning
  • Male
  • Middle Aged
  • ROC Curve
  • Retrospective Studies
  • Risk Factors
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Tissue Donors
  • Treatment Outcome