AI-LIVER: Advancing Liver Transplantation through AI-Driven Outcome Prognostication and Normothermic Perfusion Data Exchange

Liver transplantation stands as the sole curative remedy for individuals grappling with end-stage liver disease. The scarcity of donor livers poses a formidable obstacle, compounded by the substantial number of discarded organs due to viability concerns. The advent of Normothermic Machine Perfusion (NMP) during the past few years has opened a new era by employing machine perfusion to enhance liver graft viability. Normothermic perfusion has specifically emerged as a revolutionary technique, involving the assessment and reconditioning of donor livers at normal body temperature (35-37°C). This process extends liver viability and augments transplant success. While normothermic perfusion holds immense promise, it is currently hindered by the lack of comprehensive data and standardized protocols. We propose to establish an international cohort of NMP cases using a tailored digital data collection, storage, and sharing system under the PUMP consortium, the PUMP platform, and leverage machine learning and artificial intelligence to standardize protocols, identify key markers of liver viability, and predict post- operative outcomes. The project has two main objectives: to establish a international cohort of NMP cases through the usage of the PUMP platform (Aim 1) and developing a machine-learning engine to predict post-operative outcomes using the registry data (Aim 2). To achieve this, we have put together an interdisciplinary team of liver transplant surgeons, statisticians and machine- learning experts who have worked together during the past year to build the environment that will sustain the proposed project. Leveraging the robust statistical power derived from the aggregation of data from thousands of perfused liver transplants worldwide, our ultimate objective is to increase liver availability, mitigate complications, enhance patient outcomes, and provide personalized clinical decision support for physicians caring for liver transplant patients. This proposal holds the promise to fundamentally reshape the landscape of liver transplantation, ushering in advancements that stand to significantly enhance the lives of thousands of individuals awaiting liver transplants.