ArticleAnnals of medicine2026
Construction and validation of a prediction model for graft failure in pediatric liver transplant recipients based on the APRI-ALBI score: a retrospective study of 289 cases.
Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objective• • •.
backgroundTo develop and validate a preoperative APRI-ALBI-based nomogram for predicting graft failure (GF) after pediatric liver transplantation.
methodsA single-center, retrospective cohort of 289 children who underwent primary liver transplantation for end-stage liver disease between April 2017 and September 2024 was enrolled. Forty-two recipient, donor and intra-operative variables were collected. Candidate predictors were first screened by univariate Logistic/Cox analysis, further reduced by LASSO regression with 10-fold cross-validation, and finally entered into multivariable models. A nomogram integrating APRI-ALBI and other independent risk factors was constructed. Model discrimination, calibration and clinical utility were assessed with ROC analysis, calibration plots, Hosmer-Lemeshow test, decision-curve analysis (DCA) and restricted cubic splines (RCS). Kaplan-Meier curves and time-dependent ROC were used to validate 1- and 3-year GF prediction.
resultsMultivariable Logistic/Cox analysis identified six independent predictors of GF: MELD score, male donor, APRI-ALBI score, donor height, operative time and intra-operative blood loss. The resulting nomogram achieved an AUC of 0.706, outperforming PELD, MELD and Child-Pugh scores, with good calibration (Hosmer-Lemeshow
conclusionAPRI-ALBI is an independent risk factor for GF in pediatric liver transplantation. The APRI-ALBI-based nomogram offers robust discrimination, calibration and clinical utility for individual risk stratification.
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