Publication Name	World Journal of Gastroenterology
Manuscript ID	116868
Country	China

Category	Surgery
Manuscript Type	Letter to the Editor
Article Title	Early complications in split liver transplantation: An interpretable machine learning model requires multicenter validation
Manuscript Source	Invited Manuscript
All Author List	Yu-Le Ma, Hui-Gang Li, Jin-Xin Xu, Xiao Xu and Di Lu
Funding Agency and Grant Number
Corresponding Author	Di Lu, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. zjuludi@zju.edu.cn
Key Words	Split liver transplantation; Early postoperative complications; Machine learning; Systemic immune-inflammation index; Partial lobectomy of segment IV
Core Tip	This study developed an interpretable machine learning model for predicting early complications after split liver transplantation. Through novel integration of multiple algorithms with SHapley Additive exPlanations (SHAP) analysis to identify the systemic immune inflammation index, the Model for End-Stage Liver Disease score, intraoperative blood loss, and the removal of the fourth segment of the liver lobe as independent predictive factors. The SHAP analysis also made the decision-making process of the model transparent and visible - not only did it globally display the ranking of the contribution of each factor, but it could also present the specific impact of each feature on the predicted risk of individual patients. Ultimately, a visual nomogram integrating inflammation, disease severity, surgical factors, and blood loss was produced. This is an important practice in advancing liver transplantation towards precision medicine.
Citation	Ma YL, Li HG, Xu JX, Xu X, Lu D. Early complications in split liver transplantation: an interpretable machine learning model requires multicenter validation. World J Gastroenterol 2026; In press

Received	2025-11-24 04:09
Peer-Review Started	2025-11-24 04:09
First Decision by Editorial Office Director	2026-01-09 10:10
Return for Revision	2026-01-09 10:10
Revised	2026-01-20 16:48
Publication Fee Transferred
Second Decision by Editor	2026-01-30 02:29
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-01-30 04:31
Articles in Press	2026-01-30 04:31
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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