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

Tomohiro Tanaka; Daniel Sewell

doi:10.14309/ctg.0000000000000921

Back

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

Journal article

Open access

Peer reviewed

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

Tomohiro Tanaka and Daniel Sewell

Clinical and translational gastroenterology, Vol.17(1), e00921

01/2026

DOI: 10.14309/ctg.0000000000000921

PMCID: PMC12818854

PMID: 41020512

Files and links (1)

url

https://doi.org/10.14309/ctg.0000000000000921View

Published (Version of record) Open Access

Abstract

Background: 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 OPTN data from January 2022 to June 2024. Model performance was assessed using Harrell’s Concordance (C)-statistic, calibration plots, and Brier scores. Results: DRI-MP, defined as DRI × 0.7 for MP cases, improved 90-day graft survival discrimination (Harrell’s C-statistic: = 0.546 vs. 0.535, p = 0.040), while maintaining robust calibration. Conclusion: 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.

Donor Risk Index

Bayesian

Bayes statistics

OPTN

liver transplant

Details

Title: Subtitle: Refining the Liver Donor Risk Index with Machine Perfusion: A Bayesian Approach
Creators: Tomohiro Tanaka - Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA
Daniel Sewell - University of Iowa
Resource Type: Journal article
Publication Details: Clinical and translational gastroenterology, Vol.17(1), e00921
DOI: 10.14309/ctg.0000000000000921
PMID: 41020512
PMCID: PMC12818854
NLM abbreviation: Clin Transl Gastroenterol
ISSN: 2155-384X
eISSN: 2155-384X
Publisher: Wolters Kluwer Health; PHILADELPHIA
Grant note: AHRQ Mentored Clinical Scientist Research Career Development Award: K08, K08HS029195-01A1
Tomohiro Tanaka is supported by AHRQ Mentored Clinical Scientist Research Career Development Award (K08): K08HS029195-01A1.
Language: English
Electronic publication date: 09/29/2025
Date published: 01/2026
Academic Unit: Health Management and Policy; Gastroenterology and Hepatology; Biostatistics; Internal Medicine
Record Identifier: 9984966799702771

Metrics

2 Record Views