• Michael Linecker, Christoph Kuemmerli, Patryk Kambakamba, Andrea Schlegel, Paolo Muiesan, Ivan Capobianco, Silvio Nadalin, Orlando J Torres, Arianeb Mehrabi, Gregor A Stavrou, Karl J Oldhafer, Georg Lurje, Deniz Balci, Hauke Lang, Ricardo Robles-Campos, Roberto Hernandez-Alejandro, Massimo Malago, Eduardo De Santibanes, Pierre-Alain Clavien, and Henrik Petrowsky.
• Swiss HPB and Transplantation Center, Department of Surgery, University Hospital Zurich, Switzerland.
• HPB (Oxford). 2019 Jun 1; 21 (6): 711-721.

BackgroundBased on the International ALPPS registry, we have recently proposed two easily applicable risk models (pre-stage1 and 2) for predicting 90-day mortality in ALPPS but a validation of both models has not been performed yet.MethodsThe validation cohort (VC) was composed of subsequent cases of the ALPPS registry and cases of centers outside the ALPPS registry.ResultsThe VC was composed of a total of 258 patients including 70 patients outside the ALPPS registry with 32 cases of early mortalities (12%). Development cohort (DC) and VC were comparable in terms of patient and surgery characteristics. The VC validated both models with an acceptable prediction for the pre-stage 1 (c-statistic 0.64, P = 0.009 vs. 0.77, P < 0.001) and a good prediction for the pre-stage 2 model (c-statistic 0.77, P < 0.001 vs. 0.85, P < 0.001) as compared to the DC. Overall model performance measured by Brier score was comparable between VC and DC for the pre-stage 1 (0.089 vs. 0.081) and pre-stage 2 model (0.079 vs. 0087).ConclusionThe ALPPS risk score is a fully validated model to estimate the individual risk of patients undergoing ALPPS and to assist clinical decision making to avoid procedure-related early mortality after ALPPS.Copyright © 2018 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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