Intro: The present clinical research protocol is part of the LEOPARD European project (Grant n° 101080964 Horizon Europe) which aims to design and validate new predictive models of mortality among liver transplantation (LT) candidates. MELD based-liver graft allocation systems have become increasingly inaccurate over the last decade to predict mortality/dropout of liver transplantation (LT) candidates on the waitlist (WL). Wide disparities in mortality/dropout on the WL also exist across European countries, ranging from 5 to 30% according to transplantation indications and countries. In this setting, the European Commission- Horizon Europe funded-LEOPARD project intends to design new, 2nd generation, AI-machine learning-based predictive models of delisting in LT candidates, to better serve on time patients with the highest risk of dropout on the WL and to improve equity of access to LT across Europe. Hypothesis/Objective: The scientific justification of the LEOPARD TVDCS is therefore to collect a large set of data in liver transplantation candidates listed in Europe a) to design and b) to validate LEOPARD 2nd generation AI-based predictive models of mortality/dropout The primary objective is to develop new predictive models of mortality/drop out on the waitlist in patients with decompensated cirrhosis, or other end-stage chronic liver diseases, and in patients listed for Hepato-cellular carcinoma (HCC). Method: Longitudinal multicenter prospective health care data collection cohort study in 2 sets : Training/development set : Prospective health care data collection in 3,000 patients listed in 50 centres across 7 countries and Validation set: Prospective health care data collection in 1,500 subsequent patients listed in the same 50 centres.
Study Type
OBSERVATIONAL
Enrollment
4,500
Universitätsklinik für Allgemeinchirurgie, Klinische Abteilung für Transplantation
Vienna, Austria
RECRUITINGDepartment of Gastroenterology and Hepatology Universitair Ziekenhuis Gent
Ghent, Belgium
NOT_YET_RECRUITINGCHU Jean Minjoz Besançon, Department of Hepatology
Besançon, France
RECRUITINGCHU Trousseau Tours, Department of Hepatology
Chambray-lès-Tours, France
RECRUITINGCHU Beaujon, Department of Hepatology
Clichy, France
RECRUITINGHospital Henri Mondor, Department of Hepatology
Créteil, France
RECRUITINGCHU Dijon, Department of Hepatology
Dijon, France
RECRUITINGCHRU Huriez Lille, Department of Hepatology
Lille, France
RECRUITINGCHU Lyon Croix Rousse, Department of Hepatology
Lyon, France
NOT_YET_RECRUITINGCHU La Timone AP-HM, Department of Hepatology
Marseille, France
NOT_YET_RECRUITING...and 12 more locations
Clinical primary endpoint considered as the event of interest to be predicted will be a composite of number of participants with mortality or drop out for being too sick on transplantation waiting list.
* 3-month mortality/dropout for being too sick after listing in subsets 1 and 2 * 12-month mortality/dropout for being too sick (tumor progression) after listing in subset 3
Time frame: 3 months after listing in subsets 1 & 2 ; 12 months after listing in subset3
Number of participants with 6- and 9-month pre LT mortality dropout for being too sick (all subsets)
Mortality (all subsets)
Time frame: 6 and 9 months after listing
Causes of death/drop-out for being too sick
Causes of death/drop-out (all subsets)
Time frame: From date of inclusion until date of death from any cause or date of drop-out for being too sick, whichever came first, assessed up to 12 months
Incidence of delisting for patient's decision or clinical improvement
delisting for patient's decision or clinical improvement
Time frame: From date of inclusion until date of delisting for patient's decision or clinical improvement, assessed up to 12 months
Time from listing to death/dropout
Duration from listing to death/dropout (days)
Time frame: From date of listing until date of death from any cause or date of drop-out for being too sick, whichever came first, assessed up to 12 months
Time to transplantation
Duration from listing to transplantation (days)
Time frame: From date of listing until date of transplantation, assessed up to 12 months
Number of participants with 6-month and 12 month post LT survival in subsets 1 to 3
Survival in Training cohort subsets 1 to 3
Time frame: 6 months and 12 months after liver transplantation
Number of participants with 12-month HCC recurrence in subset 3
HCC recurrence in Training cohort subset 3
Time frame: 12 months after liver transplantation
Number of participants with 6-month post-LT survival (all subsets)
Survival in Validation cohort all subsets
Time frame: 6 month after liver transplantation
6-month transplant benefit (all subsets)
Relevant comorbidities (diabetes, hypertension, stroke, coronary disease, cancers, alcohol and tobacco consumption) in Validation cohort all subsets
Time frame: 6 months after liver transplantation
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