Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.103263
Revised: December 28, 2024
Accepted: February 27, 2025
Published online: April 27, 2025
Processing time: 128 Days and 15.6 Hours
Myocardial injury is common during liver transplantation and is associated with poor outcomes. The development of a reliable prediction system for this type of injury is crucial for reducing the incidence of cardiac complications in children receiving living donor liver transplantation (LDLT). However, establishing a practical myocardial injury prediction system for children with biliary atresia remains a considerable challenge.
To create and validate a nomogram model for predicting myocardial injury in children with biliary atresia who received LDLT.
Clinical data from pediatric patients who received LDLT for biliary atresia between November, 2019 and January, 2022 were retrospectively analyzed. The complete dataset was randomly partitioned into a training set and a validation set at a ratio of 7:3. Least absolute shrinkage and selection operator regression was used to preliminarily screen out the predictors of myocardial injury. The pre
This study included 321 patients, 150 (46.7%) of whom had myocardial injury. The participants were randomly allocated into two groups: A training group consisting of 225 patients and a validation group comprising 96 patients. The predictors in this nomogram included the preoperative neutrophil-to-lymphocyte ratio, high sensitivity C-reactive protein level, pediatric end-stage liver disease score and postreperfusion syndrome. The area under the curve for predicting myocardial injury was 0.865 in the training set and 0.856 in the validation set. The calibration curve revealed that the predicted values were very close to the actual values in the two sets. Decision curve analysis revealed that the prediction model offered a favorable net benefit.
The nomogram developed in this study effectively predicts myocardial injury in pediatric LDLT patients, showing good accuracy and potential for clinical application.
Core Tip: Myocardial injury is common during liver transplantation and is associated with a poor prognosis. Clinical data from pediatric patients who underwent living donor liver transplantation for biliary atresia were retrospectively analyzed. The prediction model was established via multivariable logistic regression and presented in the form of a nomogram. The predictors in this nomogram included the preoperative neutrophil-to-lymphocyte ratio, high sensitivity C-reactive protein level, pediatric end-stage liver disease score and postreperfusion syndrome. This nomogram effectively predicts myocardial injury during pediatric living donor liver transplantation, demonstrating strong discrimination, accuracy, and promising potential for clinical application.