Machine learning models for predicting acute kidney injury after pediatric living donor liver transplantation in biliary atresia

doi:10.4240/wjgs.v18.i7.120759

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jul 27, 2026; 18(7): 120759
Published online Jul 27, 2026. doi: 10.4240/wjgs.v18.i7.120759

Table 1 Comparison of various data indicators

Variable	Post-AKI = 0 (n = 241)	Post-AKI = 1 (n = 99)	P value
CIT	86.00 (67.00-112.00)	79.00 (63.50-107.50)	0.149
Anhepatic-phase-temperature	36.50 (35.80-37.00)	36.70 (36.00-37.15)	0.119
PELD	17.00 (7.00-24.00)	17.00 (11.00-28.00)	0.109
Age	8.00 (6.00-12.00)	8.00 (6.00-14.50)	0.214
Height	67.00 (63.00-75.00)	66.00 (63.00-82.00)	0.757
Weight	7.00 (6.20-9.50)	7.50 (6.50-10.60)	0.278
QTc	403.00 (386.00-423.00)	406.00 (387.00-430.00)	0.587
Pre-LVEF	64.00 (62.00-67.00)	65.00 (62.00-67.00)	0.306
Pre-ALT	102.80 (62.80-167.00)	113.40 (68.30-179.95)	0.390
Pre-AST	191.60 (118.80-301.40)	178.00 (105.75-367.00)	0.732
Pre-TB	220.20 (73.80-313.00)	243.60 (104.90-315.93)	0.320
Pre-INR	1.38 (1.12-1.75)	1.38 (1.13-1.90)	0.307
Pre-Cr	13.00 (11.00-16.00)	19.00 (13.00-26.00)	< 0.001
Pre-HB	92.98 ± 16.01	90.78 ± 16.98	0.259
Anhepatic-phase-HR	118.00 (109.00-127.00)	116.00 (105.00-125.00)	0.189
Anhepatic-phase-MAP	59.00 (53.00-66.00)	57.00 (51.00-64.00)	0.153
Anhepatic-phase-CVP	5.60 (3.00-7.00)	5.00 (4.00-8.00)	0.546
Anhepatic-phase-PH	7.39 ± 0.06	7.38 ± 0.08	0.535
Anhepatic-phase-PCO₂	33.50 (29.90-38.30)	35.60 (31.05-39.80)	0.080
Anhepatic-phase-PaO₂	254.70 (177.00-308.00)	247.00 (165.95-340.00)	0.648
Anhepatic-phase-LAC	2.60 (2.00-3.30)	3.30 (2.20-5.05)	< 0.001
Anhepatic-phase-BE	-4.50 (-6.60 to -2.70)	-4.00 (-6.90 to -1.55)	0.534
Anhepatic-phase-HB	8.20 (7.30-9.10)	8.40 (7.40-8.90)	0.721
Donor-graft-weight	243.00 (210.00-275.00)	250.00 (219.00-278.50)	0.410
Pre-re-surgery-time	270.00 (245.00-300.00)	278.00 (245.00-300.00)	0.442
Pre-re-anesthesia-time	330.00 (305.00-360.00)	340.00 (310.00-362.50)	0.426
Pre-re-blood-loss	150.00 (100.00-200.00)	150.00 (100.00-250.00)	0.244
Pre-re-blood-transfusion	1.00 (1.00-1.50)	1.00 (1.00-1.50)	0.003
Total-surgery-time	540.00 (490.00-600.00)	545.00 (492.50-600.00)	0.531
Total-anesthesia-time	618.00 (560.00-650.00)	610.00 (555.00-680.00)	0.859
Portal-blockade-time	48.00 (40.00-58.00)	47.00 (40.00-59.50)	0.764
Total-blood-loss	300.00 (200.00-400.00)	300.00 (200.00-500.00)	0.224
Total-urine-output	400.00 (260.00-600.00)	400.00 (280.00-560.00)	0.688
Total-blood-transfusion	2.00 (1.50-3.00)	2.00 (2.00-3.00)	0.005
Total-FFP	0.00 (0.00-101.00)	0.00 (0.00-200.00)	0.006
Total-fluid-transfusion	1380.00 (1120.00-1765.00)	1447.00 (1155.50-1756.75)	0.803
Extubation-time	204.00 (138.00-318.00)	230.00 (156.00-380.50)	0.084
ICU-stay	2.50 (2.00-3.00)	3.00 (2.00-5.00)	0.016
Hospital-stay	21.00 (16.00-26.00)	22.00 (18.00-29.00)	0.081
Post-ALT	585.40 (403.80-976.20)	584.80 (380.35-1287.15)	0.609
Post-AST	666.70 (481.30-1182.00)	898.60 (537.55-1529.20)	0.011
Post-TB	80.30 (56.50-114.19)	102.11 (67.22-142.57)	0.008
Post-Cr	14.00 (12.00-17.00)	21.00 (16.00-34.00)	< 0.001
Anhepatic-phase-K⁺	3.80 (3.40-4.10)	3.60 (3.35-4.00)	0.099
Anhepatic-phase-Ca²⁺	1.09 (1.02-1.17)	1.08 (0.97-1.13)	0.006
Anhepatic-phase-Na⁺	139.00 (136.00-142.00)	140.00 (138.00-145.00)	0.006
Anhepatic-phase-Cl^-	106.00 (103.00-111.00)	108.00 (103.00-112.00)	0.161
PFO, n (%)	63/241 (26.14)	18/99 (18.18)	0.203
Male, n (%)	110/241 (45.64)	59/99 (59.60)	0.002
PRS, n (%)	106/241 (43.98)	37/99 (37.37)	0.536

HR: Heart rate; MAP: Mean arterial pressure; CVP: Central venous pressure; PH: PH value; PCO₂: Partial pressure of carbon dioxide; PaO₂: Arterial partial pressure of oxygen; LAC: Lactate; BE: Base excess; Ca²⁺: Calcium ion; K⁺: Potassium ion; HB: Hemoglobin; Pre-re: Pre-reperfusion; CIT: Cold ischemia time; PELD: Pediatric End-Stage Liver Disease Score; QTc: Corrected QT interval; LVEF: Left ventricular ejection fraction; ALT: Preoperative alanine aminotransferase; AST: Aspartate aminotransferase; TB: Total bilirubin; INR: International normalized ratio; Cr: Creatinine; PRS: Postreperfusion syndrome; PFO: Patent foramen ovale; AKI: Acute kidney injury; FFP: Fresh frozen plasma.

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Table 2 Summary of model performance comparison

Model	Accuracy (mean)	Accuracy (95%CI)	Precision (mean)	Precision (95%CI)	Recall (mean)	Recall (95%CI)	F1 score (mean)	F1 score (95%CI)	AUC (mean)	AUC (95%CI)
Random forest	0.842	0.783-0.902	0.805	0.663-0.947	0.599	0.478-0.720	0.678	0.563-0.793	0.875	0.805-0.944
XGBoost	0.806	0.740-0.872	0.685	0.560-0.810	0.634	0.484-0.785	0.641	0.532-0.751	0.848	0.771-0.925
Gradient boosting	0.809	0.759-0.859	0.706	0.585-0.827	0.611	0.481-0.741	0.636	0.547-0.726	0.841	0.764-0.917
AdaBoost	0.818	0.758-0.879	0.74	0.594-0.885	0.544	0.408-0.681	0.619	0.489-0.750	0.824	0.730-0.917
KNN	0.782	0.739-0.825	0.677	0.544-0.810	0.468	0.344-0.592	0.533	0.424-0.641	0.823	0.766-0.880
MLP	0.8	0.763-0.837	0.661	0.587-0.735	0.612	0.476-0.749	0.62	0.540-0.701	0.816	0.739-0.892
SVM	0.812	0.766-0.859	0.748	0.624-0.873	0.521	0.396-0.647	0.598	0.492-0.705	0.81	0.748-0.872
Logistic regression	0.788	0.740-0.836	0.689	0.535-0.843	0.444	0.334-0.555	0.533	0.416-0.651	0.79	0.708-0.873
Decision tree	0.779	0.712-0.846	0.638	0.498-0.778	0.631	0.521-0.741	0.619	0.524-0.714	0.734	0.664-0.803

KNN: K-nearest neighbors; MLP: Multilayer perceptron; SVM: Support vector machine; AUC: Area under the curve; CI: Confidence interval.

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Citation: Wang RR, Zhu M, Ren HC, Yu WL. Machine learning models for predicting acute kidney injury after pediatric living donor liver transplantation in biliary atresia. World J Gastrointest Surg 2026; 18(7): 120759
URL: https://www.wjgnet.com/1948-9366/full/v18/i7/120759.htm
DOI: https://dx.doi.org/10.4240/wjgs.v18.i7.120759

Wang RR, Zhu M, Ren HC, Yu WL. Machine learning models for predicting acute kidney injury after pediatric living donor liver transplantation in biliary atresia. World J Gastrointest Surg 2026; 18(7): 120759 [DOI: 10.4240/wjgs.v18.i7.120759]

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