External validation of the Donor Risk Index and the Eurotransplant Donor Risk Index on the French liver transplantation registry
Background & Aims A major limitation to liver transplantation is organ shortage leading to the use of non‐optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objectiv...
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Published in | Liver international Vol. 37; no. 8; pp. 1229 - 1238 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Wiley Subscription Services, Inc
01.08.2017
Wiley-Blackwell |
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Abstract | Background & Aims
A major limitation to liver transplantation is organ shortage leading to the use of non‐optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant‐Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis.
Methods
Liver transplantations performed in France between 2009 and 2013 were used to perform the validation study for the Donor Risk Index and the Eurotransplant‐Donor Risk Index respectively. We applied on the French data the models used to construct the Donor Risk Index and the Eurotransplant‐Donor Risk Index respectively.
Results
Neither the Donor Risk Index nor the Eurotransplant‐Donor Risk Index were validated against this dataset. Discrimination and calibration of these scores were not preserved according to our data. Important donor and candidates differences between our dataset and the Organ Procurement and Transplantation Network or the Eurotransplant datasets may explain why the Donor Risk Index and the Eurotransplant‐Donor Risk Index appeared unadapted to the French transplant registry.
Conclusion
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. |
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AbstractList | BACKGROUND & AIMSA major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant-Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis.METHODSLiver transplantations performed in France between 2009 and 2013 were used to perform the validation study for the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively. We applied on the French data the models used to construct the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively.RESULTSNeither the Donor Risk Index nor the Eurotransplant-Donor Risk Index were validated against this dataset. Discrimination and calibration of these scores were not preserved according to our data. Important donor and candidates differences between our dataset and the Organ Procurement and Transplantation Network or the Eurotransplant datasets may explain why the Donor Risk Index and the Eurotransplant-Donor Risk Index appeared unadapted to the French transplant registry.CONCLUSIONNeither 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. Background & Aims A major limitation to liver transplantation is organ shortage leading to the use of non‐optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant‐Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis. Methods Liver transplantations performed in France between 2009 and 2013 were used to perform the validation study for the Donor Risk Index and the Eurotransplant‐Donor Risk Index respectively. We applied on the French data the models used to construct the Donor Risk Index and the Eurotransplant‐Donor Risk Index respectively. Results Neither the Donor Risk Index nor the Eurotransplant‐Donor Risk Index were validated against this dataset. Discrimination and calibration of these scores were not preserved according to our data. Important donor and candidates differences between our dataset and the Organ Procurement and Transplantation Network or the Eurotransplant datasets may explain why the Donor Risk Index and the Eurotransplant‐Donor Risk Index appeared unadapted to the French transplant registry. Conclusion 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. BACKGROUND & AIMS:A major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant-Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis.METHODS:Liver transplantations performed in France between 2009 and 2013 were used to perform the validation study for the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively. We applied on the French data the models used to construct the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively.RESULTS:Neither the Donor Risk Index nor the Eurotransplant-Donor Risk Index were validated against this dataset. Discrimination and calibration of these scores were not preserved according to our data. Important donor and candidates differences between our dataset and the Organ Procurement and Transplantation Network or the Eurotransplant datasets may explain why the Donor Risk Index and the Eurotransplant-Donor Risk Index appeared unadapted to the French transplant registry.CONCLUSION: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. A major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant-Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis. Liver transplantations performed in France between 2009 and 2013 were used to perform the validation study for the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively. We applied on the French data the models used to construct the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively. Neither the Donor Risk Index nor the Eurotransplant-Donor Risk Index were validated against this dataset. Discrimination and calibration of these scores were not preserved according to our data. Important donor and candidates differences between our dataset and the Organ Procurement and Transplantation Network or the Eurotransplant datasets may explain why the Donor Risk Index and the Eurotransplant-Donor Risk Index appeared unadapted to the French transplant registry. 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. Abstract Background & Aims A major limitation to liver transplantation is organ shortage leading to the use of non‐optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant‐Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis . Methods Liver transplantations performed in France between 2009 and 2013 were used to perform the validation study for the Donor Risk Index and the Eurotransplant‐Donor Risk Index respectively. We applied on the French data the models used to construct the Donor Risk Index and the Eurotransplant‐Donor Risk Index respectively. Results Neither the Donor Risk Index nor the Eurotransplant‐Donor Risk Index were validated against this dataset. Discrimination and calibration of these scores were not preserved according to our data. Important donor and candidates differences between our dataset and the Organ Procurement and Transplantation Network or the Eurotransplant datasets may explain why the Donor Risk Index and the Eurotransplant‐Donor Risk Index appeared unadapted to the French transplant registry. Conclusion 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. |
Author | Féray, Cyrille Landais, Paul Winter, Audrey Écochard, René Jacquelinet, Christian Daurès, Jean‐Pierre Duvoux, Christophe Audureau, Etienne Roudot‐Thoraval, Françoise |
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Cites_doi | 10.1093/biomet/92.4.965 10.1136/bmj.b606 10.1111/j.1600-6143.2006.01242.x 10.1186/1477-5751-12-18 10.1053/j.gastro.2012.05.052 10.1002/sim.4780100805 10.1080/07357900802572110 10.1111/j.1600-6143.2007.02086.x 10.1097/01.sla.0000234896.18207.fa 10.1002/sim.1621 10.1001/jama.1982.03320430047030 10.1111/j.1600-6143.2012.04195.x 10.1002/lt.22447 10.1186/1471-2288-13-33 10.1002/1097-0258(20001230)19:24<3401::AID-SIM554>3.0.CO;2-2 10.7326/M14-0698 |
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Keywords | external validation prognostic score donor risk liver transplantation |
Language | English |
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A major limitation to liver transplantation is organ shortage leading to the use of non‐optimal liver grafts. The Donor Risk Index has been... A major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been validated and... Abstract Background & Aims A major limitation to liver transplantation is organ shortage leading to the use of non‐optimal liver grafts. The Donor Risk Index... Background & Aims A major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been... BACKGROUND & AIMSA major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been... BACKGROUND & AIMS:A major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been... |
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SubjectTerms | Adaptive systems Adolescent Adult Aged Child Child, Preschool donor risk external validation Female France Grafts Human health and pathology Humans Hépatology and Gastroenterology Infant Life Sciences Liver Liver Transplantation Male Middle Aged Optimization Organs prognostic score Registries Risk Risk Assessment Tissue Donors - statistics & numerical data Transplantation Transplants & implants Young Adult |
Title | External validation of the Donor Risk Index and the Eurotransplant Donor Risk Index on the French liver transplantation registry |
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