{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:13:51Z","timestamp":1790604831500,"version":"4.1.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and internally validate a nomogram for early postoperative prediction of acute kidney injury (AKI) within 7 days after orthotopic liver transplantation (LT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 500 orthotopic liver transplants at the First Affiliated Hospital of Sun Yat-sen University (January 1, 2016\u2013April 30, 2022). Patients were randomly split into training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009352) and validation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009148) cohorts for same-center internal validation using a random-split design. AKI within 7 postoperative days was defined by KDIGO serum-creatinine criteria only (KDIGO-SCr) because urine-output data were incomplete. Candidate predictors were screened using least absolute shrinkage and selection operator (LASSO) and entered into multivariable logistic regression to build a parsimonious nomogram for early postoperative (first 6\u201312\u2005h) risk stratification and monitoring. Performance was assessed by AUC and calibration; decision-curve analysis illustrated relative net benefit without prespecified thresholds or actions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      BMI, operation time, intraoperative urine volume, and postoperative levels of urea nitrogen, blood ammonia, and procalcitonin were identified as independent risk factors for AKI after LT (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). The nomogram demonstrated good discrimination, calibration, and clinical usefulness in both the training and validation cohorts, with an AUC of 0.769 (95% CI: 0.715\u20130.823) in the training cohort and 0.704 (95% CI: 0.618\u20130.790) in the validation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The nomogram predictive model developed in this study shows good accuracy and can be conveniently applied for early identification and risk prediction of acute kidney injury following liver transplantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1683424","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T06:22:50Z","timestamp":1763446970000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development of a risk prediction model for acute kidney injury in liver transplant recipients"],"prefix":"10.3389","volume":"12","author":[{"given":"Dahui","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanchen","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kangqing","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiehua","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1111\/liv.12553","article-title":"Liver transplantation: a systematic review of long-term quality of life","volume":"34","author":"Yang","year":"2014","journal-title":"Liver Int"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3634","DOI":"10.1016\/j.transproceed.2010.08.059","article-title":"Strong impact of acute kidney injury on survival after liver transplantation","volume":"42","author":"Zhu","year":"2010","journal-title":"Transplant Proc"},{"key":"B3","doi-asserted-by":"publisher","first-page":"372","DOI":"10.3390\/jcm8030372","article-title":"Incidence and impact of acute kidney injury after liver transplantation: a meta-analysis","volume":"8","author":"Thongprayoon","year":"2019","journal-title":"J Clin Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e429","DOI":"10.1097\/TXD.0000000000000868","article-title":"Early persistent progressive acute kidney injury and graft failure post liver transplantation","volume":"5","author":"Hussaini","year":"2019","journal-title":"Transplant Direct"},{"key":"B5","doi-asserted-by":"publisher","first-page":"6168","DOI":"10.21037\/apm-21-842","article-title":"A prediction score model and survival analysis of acute kidney injury following orthotopic liver transplantation in adults","volume":"10","author":"Bao","year":"2021","journal-title":"Ann Palliat Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.6002\/ect.2021.0300","article-title":"Acute kidney injury after liver transplant: incidence, risk factors, and impact on patient outcomes","volume":"19","author":"Arani","year":"2021","journal-title":"Exp Clin Transplant"},{"key":"B7","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1016\/S1665-2681(19)30763-X","article-title":"Risk factors for acute kidney injury and 30-day mortality after liver transplantation","volume":"14","author":"Barreto","year":"2015","journal-title":"Ann Hepatol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e2320","DOI":"10.1097\/MD.0000000000002320","article-title":"Incidence and outcomes of acute renal failure following liver transplantation","volume":"94","author":"Chen","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1186\/s12882-020-01871-0","article-title":"Association of overweight with postoperative acute kidney injury among patients receiving orthotopic liver transplantation: an observational cohort study","volume":"21","author":"Zhou","year":"2020","journal-title":"BMC Nephrol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1007\/s11596-017-1818-5","article-title":"Risk factors for acute kidney injury after orthotopic liver transplantation: a single-center data analysis","volume":"37","author":"Zhou","year":"2017","journal-title":"J Huazhong Univ Sci Technolog Med Sci"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.1016\/S0041-1345(03)00598-0","article-title":"Does the standard vs piggyback surgical technique affect the development of early acute renal failure after orthotopic liver transplantation?","volume":"35","author":"Cabezuelo","year":"2003","journal-title":"Transplant Proc"},{"key":"B12","first-page":"25","article-title":"Effects of surgical technique on postoperative renal function after orthotopic liver transplant","volume":"7","author":"Nikeghbalian","year":"2009","journal-title":"Exp Clin Transplant"},{"key":"B13","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1081\/JDI-120022546","article-title":"Risk factors for development of acute renal failure after liver transplantation","volume":"25","author":"Lima","year":"2003","journal-title":"Renal Fail"},{"key":"B14","first-page":"1003","article-title":"The influential factors and clinical significance of acute renal failure complicated to orthotopic liver transplantation","volume":"49","author":"Yuan","year":"2011","journal-title":"Zhonghua Wai Ke Za Zhi"},{"key":"B15","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1016\/j.hpb.2016.04.004","article-title":"Acute kidney injury following hepatectomy for hepatocellular carcinoma: incidence, risk factors and prognostic value","volume":"18","author":"Lim","year":"2016","journal-title":"HPB (Oxford)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"4589767","DOI":"10.1155\/2022\/4589767","article-title":"Acute kidney injury in patients with liver cirrhosis: prevalence, predictors, and in-hospital mortality at a district hospital in Ghana","volume":"2022","author":"Duah","year":"2022","journal-title":"BioMed Res Int"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1877","DOI":"10.1097\/TP.0000000000002584","article-title":"Intraoperative hemodynamic parameters and acute kidney injury after living donor liver transplantation","volume":"103","author":"Kim","year":"2019","journal-title":"Transplantation"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.3390\/medicina59061099","article-title":"Predicting post-hepatectomy liver failure in HCC patients: a review of liver function assessment based on laboratory tests scores","volume":"59","author":"Morandi","year":"2023","journal-title":"Medicina"},{"key":"B19","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1200\/JCO.2014.57.9151","article-title":"Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade","volume":"33","author":"Johnson","year":"2015","journal-title":"J Clin Oncol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"S100","DOI":"10.1016\/j.jhep.2004.11.015","article-title":"Assessment of the prognosis of cirrhosis: child-pugh versus MELD","volume":"42","author":"Durand","year":"2005","journal-title":"J Hepatol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"4773","DOI":"10.1038\/s41598-018-22923-4","article-title":"Comparison of twelve liver functional reserve models for outcome prediction in patients with hepatocellular carcinoma undergoing surgical resection","volume":"8","author":"Ho","year":"2018","journal-title":"Sci Rep"},{"key":"B22","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1002\/lt.22091","article-title":"Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors","volume":"16","author":"Olthoff","year":"2010","journal-title":"Liver Transpl"},{"key":"B23","doi-asserted-by":"publisher","first-page":"4183","DOI":"10.1053\/j.jvca.2022.05.027","article-title":"2021 clinical update in liver transplantation","volume":"36","author":"Kassel","year":"2022","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"B24","doi-asserted-by":"publisher","first-page":"10887","DOI":"10.3389\/ti.2023.10887","article-title":"A novel online calculator predicting acute kidney injury after liver transplantation: a retrospective study","volume":"36","author":"Zeng","year":"2023","journal-title":"Transpl Int"},{"key":"B25","doi-asserted-by":"publisher","first-page":"iv42","DOI":"10.1093\/ndt\/gft331","article-title":"Body mass index and body fat distribution as renal risk factors: a focus on the role of renal haemodynamics","volume":"28","author":"Kwakernaak","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"B26","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1111\/apt.14139","article-title":"Systematic review with meta-analysis: post-operative complications and mortality risk in liver transplant candidates with obesity","volume":"46","author":"Barone","year":"2017","journal-title":"Aliment Pharmacol Ther"},{"key":"B27","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s12871-015-0096-7","article-title":"Obesity\u2013a risk factor for postoperative complications in general surgery?","volume":"15","author":"Tjeertes","year":"2015","journal-title":"BMC Anesthesiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1186\/cc13152","article-title":"The obesity paradox and acute kidney injury: beneficial effects of hyper-inflammation?","volume":"17","author":"Hafner","year":"2013","journal-title":"Crit Care"},{"key":"B29","doi-asserted-by":"publisher","first-page":"694.e1","DOI":"10.1016\/j.jcrc.2014.02.021","article-title":"Obesity and perioperative acute kidney injury: a focused review","volume":"29","author":"Suneja","year":"2014","journal-title":"J Crit Care"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1681\/ASN.2011090940","article-title":"Obesity and oxidative stress predict AKI after cardiac surgery","volume":"23","author":"Billings","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e0136230","DOI":"10.1371\/journal.pone.0136230","article-title":"Clinical risk scoring models for prediction of acute kidney injury after living donor liver transplantation: a retrospective observational study","volume":"10","author":"Park","year":"2015","journal-title":"PLoS One"},{"key":"B32","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1080\/0886022X.2022.2061997","article-title":"Intraoperative vasopressor use and early postoperative acute kidney injury in elderly patients undergoing elective noncardiac surgery","volume":"44","author":"Ariyarathna","year":"2022","journal-title":"Renal Fail"},{"key":"B33","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.amjsurg.2024.02.001","article-title":"Intraoperative hypotension and postoperative acute kidney injury: a systematic review","volume":"232","author":"Penev","year":"2024","journal-title":"Am J Surg"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1016\/j.hpb.2019.04.008","article-title":"The AKI prediction score: a new prediction model for acute kidney injury after liver transplantation","volume":"21","author":"Kalisvaart","year":"2019","journal-title":"HPB (Oxford)"},{"key":"B35","doi-asserted-by":"publisher","first-page":"e31895","DOI":"10.1097\/MD.0000000000031895","article-title":"Clinical usefulness of biomarkers for diagnosis and prediction of prognosis in sepsis and septic shock","volume":"101","author":"Lee","year":"2022","journal-title":"Medicine (Baltimore)"},{"key":"B36","doi-asserted-by":"publisher","first-page":"e24999","DOI":"10.1097\/MD.0000000000024999","article-title":"Meta-analysis of procalcitonin as a predictor for acute kidney injury","volume":"100","author":"Feng","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"B37","doi-asserted-by":"publisher","first-page":"e82250","DOI":"10.1371\/journal.pone.0082250","article-title":"Procalcitonin levels predict acute kidney injury and prognosis in acute pancreatitis: a prospective study","volume":"8","author":"Huang","year":"2013","journal-title":"PLoS One"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1515\/cclm-2012-0822","article-title":"Serum procalcitonin predicts development of acute kidney injury in patients with suspected infection","volume":"51","author":"Nie","year":"2013","journal-title":"Clin Chem Lab Med"},{"key":"B39","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1177\/0003319715572218","article-title":"Procalcitonin as an early predictor of contrast-induced acute kidney injury in patients with acute coronary syndromes who underwent percutaneous coronary intervention","volume":"66","author":"Kurtul","year":"2015","journal-title":"Angiology"},{"key":"B40","doi-asserted-by":"publisher","first-page":"207","DOI":"10.3389\/fendo.2018.00207","article-title":"Therapeutic interference with vascular calcification-lessons from klotho-hypomorphic mice and beyond","volume":"9","author":"Lang","year":"2018","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B41","doi-asserted-by":"publisher","first-page":"111840","DOI":"10.1016\/j.celrep.2022.111840","article-title":"Kir4.2 mediates proximal potassium effects on glutaminase activity and kidney injury","volume":"41","author":"Terker","year":"2022","journal-title":"Cell Rep"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.3390\/jcm9061629","article-title":"Liver transplant patients with high levels of preoperative serum ammonia are at increased risk for postoperative acute kidney injury: a retrospective study","volume":"9","author":"Lee","year":"2020","journal-title":"J Clin Med"},{"key":"B43","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.repc.2015.06.006","article-title":"Acute kidney injury after pediatric cardiac surgery: risk factors and outcomes. Proposal for a predictive model","volume":"35","author":"Cardoso","year":"2016","journal-title":"Rev Port Cardiol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.4103\/0366-6999.230726","article-title":"Predictive value of serum creatinine, blood urea nitrogen, uric acid, and \u03b2 2-microglobulin in the evaluation of acute kidney injury after orthotopic liver transplantation","volume":"131","author":"Lu","year":"2018","journal-title":"Chin Med J"},{"key":"B45","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.lers.2025.01.001","article-title":"A comprehensive step-by-step approach for the implementation of target trial emulation: evaluating fluid resuscitation strategies in post-laparoscopic septic shock as an example","volume":"8","author":"Yang","year":"2025","journal-title":"Laparosc Endosc Rob Surg"},{"key":"B46","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.lers.2024.02.001","article-title":"Identification of clinical subphenotypes of sepsis after laparoscopic surgery","volume":"7","author":"Yang","year":"2024","journal-title":"Laparosc Endosc Rob Surg"},{"key":"B47","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.cld.2016.12.004","article-title":"Extended criteria donors in liver transplantation","volume":"21","author":"Vodkin","year":"2017","journal-title":"Clin Liver Dis"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1683424\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T06:22:51Z","timestamp":1763446971000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1683424\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":47,"alternative-id":["10.3389\/fsurg.2025.1683424"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1683424","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,18]]},"article-number":"1683424"}}