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. 2022 Apr 19;6(5):712–725. doi: 10.1002/ags3.12573

FIGURE 3.

FIGURE 3

Development and validation of a new risk model for 1‐year graft loss in Japan. (A) Variable selection using the least absolute shrinkage and selection operator (LASSO) logistic regression model. Fourteen variables were selected by LASSO logistic regression analysis. Two dotted vertical lines mark the optimal values of lambda (λ) by minimum criteria and 1‐standard error criteria. (B) LASSO coefficient profiles of the 20 variables. The numbers assigned for each curve show each variable as follows: re‐transplantation (1), encephalopathy: ≥Ⅲ (2), medical condition in ICU (3), MELD score (20‐29 [4], 30‐39 [5], ≥40 [6]), donor age (40‐59 years [7], 60‐69 years [8], ≥70 years [9]), catecholamine index (10.0‐29.9 [10], ≥30.0 [11]), maximum sodium level (160‐179 mEq/L [12], ≥180 mEq/L [13]), maximum total bilirubin level (3.0‐4.9 mg/dL [14], ≥5.0 mg/dL [15]), total ischemic time (9.0‐10.9 h [16], 11.0‐12.9 h [17], ≥13.0 h [18]), and transplantation era (Era2 [19], Era3 [20]). A vertical line indicates the optimal value of lambda based on by the least mean square error, which gives 14 nonzero coefficients. (C) The Japan Risk Index (JRI) was assessed through 5‐fold cross‐validation using the full sample of 449 participants for internal validation. Across the folds, the model had a mean C‐statistic of 0.81 and a standard deviation of 0.02. (D) Ability of the previous risk models to discriminate 1‐year graft loss. The C‐statistic was calculated for each model. The C‐statistics for all previously reported models were below 0.70. (E) Graft survival following DDLT according to risk scores. The 1‐year graft survival rate worsened significantly as the risk score increased (P < 0.001). The following three groups were obtained based on survival rates: low‐risk (JRI < 3), moderate‐risk (3 ≤ JRI < 6), and high‐risk (JRI ≥6). BAR, Balance of Risk; DDLT, deceased donor liver transplantation; DLI, Donor Liver Index; DLI1, Donor Liver Index for 1‐year graft survival; D‐MELD, Donor Age and Recipient Model for End‐Stage Liver Disease; DQI, Donor Quality Index; DRI, Donor Risk Index; ET‐DRI, Eurotransplant Donor Risk Index; ICU, intensive care unit; JRI, Japan Risk Index; LASSO, least absolute shrinkage and selection operator; MELD, Model for End–stage Liver Disease; SOFT, Survival Outcomes Following Liver Transplantation