{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T10:00:43Z","timestamp":1781690443395,"version":"3.54.5"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Background.<\/jats:title>\n Following therapeutic advancements, recompensation has gained increasing recognition in patients on waitlist for liver transplantation (LT). Identifying key predictors of waitlist removal because of improvement can enhance prognostication and resource allocation. We hence examined predictors of improvement-related waitlist removal using a machine learning-based approach with data from the United Network for Organ Sharing database.<\/jats:p>\n <\/jats:sec>\n \n Methods.<\/jats:title>\n In this retrospective cohort study, adult LT waitlist candidates from 2000 to 2025 in the United Network for Organ Sharing registry were included. A random survival forest model was applied to examine key predictors associated with improvement-related waitlist removal, while accounting for death and LT as competing risks. Variable importance (VIMP) measure and minimal depth were used to guide variable selection. Model performance was evaluated using the concordance index, Brier scores, and time-dependent area under the curve.<\/jats:p>\n <\/jats:sec>\n \n Results.<\/jats:title>\n The cohort included 127\u2009978 individuals listed for LT. Eight thousand four hundred ninety-three (6.6%) were delisted because of clinical improvement. The random survival forest model demonstrated strong performance and discriminatory ability overall at 1, 5, and 15 y (concordance index was 0.777, 0.771, and 0.781; time-dependent area under the curve was 0.78, 0.78, and 0.80). Brier scores were reduced relative to the reference. Strong predictors of recovery highlighted in both VIMP and minimal depth-based assessments of VIMP included diagnosis, age, and serum albumin.<\/jats:p>\n <\/jats:sec>\n \n Conclusions.<\/jats:title>\n Identified variables could inform the development of robust predictive models to guide individualized decision-making for LT. With further validation and integration into clinical workflows, such models could enhance prognostication of patient trajectory on the LT waitlist and facilitate appropriate resource allocation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/tp.0000000000005705","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:00:42Z","timestamp":1781643642000},"page":"e1447-e1455","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Delisting From Clinical Improvement in Liver Cirrhosis: A Machine Learning Decision Tree Analysis"],"prefix":"10.1097","volume":"110","author":[{"given":"Nicole Shu Ying","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret L.P.","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."},{"name":"National University Centre for Digestive Health, National University Hospital, Singapore, Singapore."},{"name":"Division of Gastroenterology, Department of Medicine, Alexandra Hospital, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asvin","family":"Selvakumar","sequence":"additional","affiliation":[{"name":"National University Centre for Digestive Health, National University Hospital, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caleb Wei Hao","family":"Ng","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, National University Hospital, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. Apoorva","family":"Sasikumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Yao Pierre","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Life Science & Chemical Technology, Ngee Ann Polytechnic, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghyun","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Medicine, Bridgeport Hospital Yale New Haven Health, Bridgeport, CT."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard Tzu-Hao","family":"Lee","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Kow","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pojsakorn","family":"Danpanichkul","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Muthiah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."},{"name":"National University Centre for Digestive Health, National University Hospital, Singapore, Singapore."},{"name":"National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karn","family":"Wijarnpreecha","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Arizona College of Medicine Phoenix, Phoenix, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Mook","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng Han","family":"Ng","sequence":"additional","affiliation":[{"name":"National University Centre for Digestive Health, National University Hospital, Singapore, Singapore."},{"name":"Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Syn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavish R.","family":"Patidar","sequence":"additional","affiliation":[{"name":"Houston Methodist Hospital and Houston Research Institute, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel A.","family":"Tsochatzis","sequence":"additional","affiliation":[{"name":"UCL Institute of Liver and Digestive Health, University College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Shadab","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice Xiang-Xuan","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."},{"name":"National University Centre for Digestive Health, National University Hospital, Singapore, Singapore."},{"name":"National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"R1-20260616","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.jhep.2018.09.014","article-title":"Burden of liver diseases in the 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