External validation of the Donor Risk Index and the Eurotransplant Donor Risk Index on the French liver transplantation registry

Winter, Audrey; Féray, Cyrille; Audureau, Étienne; Écochard, René; Jacquelinet, Christian; Roudot‐Thoraval, Françoise; Duvoux, Christophe; Daurès, Jean‐Pierre; Landais, Paul

doi:10.1111/liv.13378

Cited by 19 publications

(28 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The latest indicators based on neural networks are complex, rely on limited experience, are scarcely generalizable and are also difficult to extrapolate to the daily clinical practice (9,10). Finally, external validations for some indicators (DRI, MELD, D-MELD and SOFT [7], DRI and ET-DRI [13], DRI and SOFT [10]) do not confirm their validity when applied to scenarios different to their principal intended use, as is the case in our study. The latter point likely results from large differences between countries and programs, in terms of donor population and donation-transplantation process characteristics and not so much with recipient characteristics.…”

Section: Discussioncontrasting

confidence: 73%

Graft survival after liver transplantation: an approach to a new Spanish risk index

et al. 2018

View full text Add to dashboard Cite

Introduction: several indicators are available to assess liver graft survival, including the American DRI and the European ET-DRI. However, there are significant differences between transplant programs of different countries, and the previously mentioned indicators might be not valid in our setting. Objectives: the aim of the study was to describe a new national liver graft risk indicator based on the results obtained from the Registro Español de Trasplante Hepático (RETH) and to validate the DRI and ET-DRI indicators. Methods: the RETH includes a Cox analysis of factors associated with graft survival; the graft risk index (GRI) indicator was defined based on these results. The variables considered are dependent upon the donation conditions (age, cause of death, blood compatibility and cold ischemia time) and the transplant recipient (age, underlying disease, hepatitis C virus, transplant number, UNOS status and surgical technique). A logistic regression curve was obtained and graft survival curves were calculated by stratification. Precision was assessed using the ROC analysis. Results: a GRI of 1 represents a probability of graft loss of 23.25%; each point increase in the GRI score multiplies this probability by 1.33. The best discrimination of GRI was obtained by stratification. The DRI ROC area was 0.54 (95% CI, 0.50-0.59) and the ET-DRI ROC area was 0.56 (95% CI, 0.51-0.61), compared to 0.70 (95% CI, 0.65-0.73) (p < 0.0001) for the GRI.

show abstract

Section: Discussioncontrasting

confidence: 73%

Graft survival after liver transplantation: an approach to a new Spanish risk index

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Survival differences were predominantly driven by events in the first year . However, later validation studies assigned a lower C‐statistic of 0.48‐0.52 . A refinement of ET‐DRI that combined recipient factors showed a significantly higher c‐index of 0.62 versus 0.59 ( P < 0.001) …”

Section: Limitations and Barriers To Acceptancementioning

confidence: 96%

The donor risk index: A decade of experience

Flores

Asrani

2017

Liver Transpl

View full text Add to dashboard Cite

In 2006, derivation of the donor risk index (DRI) highlighted the importance of donor factors for successful liver transplantation. Over the last decade, the DRI has served as a useful metric of donor quality and has enhanced our understanding of donor factors and their impact upon recipients with hepatitis C virus, those with low Model for End-Stage Liver Disease (MELD) score, and individuals undergoing retransplantation. DRI has provided the transplant community with a common language for describing donor organ characteristics and has served as the foundation for several tools for organ risk assessment. It is a useful tool in assessing the interactions of donor factors with recipient factors and their impact on posttransplant outcomes. However, limitations of statistical modeling, choice of donor factors, exclusion of unaccounted donor and geographic factors, and the changing face of the liver transplant recipient have tempered its widespread use. In addition, the DRI was derived from data before the MELD era but is currently being applied to expand the donor pool while concurrently meeting the demands of a dynamic allocation system. A decade after its introduction, DRI remains relevant but may benefit from being updated to provide guidance in the use of extended criteria donors by accounting for the impact of geography and unmeasured donor characteristics. DRI could be better adapted for recipients with nonalcoholic fatty liver disease by examining and including recipient factors unique to this population. Liver Transplantation 23 1216-1225 2017 AASLD.

show abstract

“…However, the accuracy in predicting outcome after LT has been shown to be relatively low, with C-statistics around 0,5 when validated externally 265 . It has later been refined and combined with a simplified recipient risk index (sRII) achieving a somewhat better c-statistic of 0.62 266 .…”

Section: Donor and Recipient Matchingmentioning

confidence: 99%

Transplantation With Livers From Deceased Donors Older Than 75 Years

et al. 2015

View full text Add to dashboard Cite

show abstract

External validation of the Donor Risk Index and the Eurotransplant Donor Risk Index on the French liver transplantation registry

Abstract: Neither of these risk indexes were suitable to optimize the French liver allocation system. Thus, our next step will be to propose a general adaptive model for a Donor Risk Index.

Cited by 19 publications

References 18 publications

Graft survival after liver transplantation: an approach to a new Spanish risk index

Graft survival after liver transplantation: an approach to a new Spanish risk index

The donor risk index: A decade of experience

Transplantation With Livers From Deceased Donors Older Than 75 Years

Contact Info

Product

Resources

About