A Transformer-Based Deep Learning Approach for Fairly Predicting Post-Liver Transplant Risk Factors

Liver transplantation is a life-saving procedure for patients with end-stage liver disease. There are two main challenges in liver transplant: finding the best matching patient for a donor and ensuring transplant equity among different subpopulations. The current MELD scoring system evaluates a patient's mortality risk if not receiving an organ within 90 days. However, the donor-patient matching should also take into consideration post-transplant risk factors, such as cardiovascular disease, chronic rejection, etc., which are all common complications after transplant. Accurate prediction of these risk scores remains a significant challenge. In this study, we will use predictive models to solve the above challenge. We propose a deep learning framework model to predict multiple risk factors after a liver transplant. By formulating it as a multi-task learning problem, the proposed deep neural network was trained on this data to simultaneously predict the five post-transplant risks and achieve equally good performance by leveraging task balancing techniques. We also propose a novel fairness achieving algorithm and to ensure prediction fairness across different subpopulations. We used electronic health records of 160,360 liver transplant patients, including demographic information, clinical variables, and laboratory values, collected from the liver transplant records of the United States from 1987 to 2018. The performance of the model was evaluated using various performance metrics such as AUROC, AURPC, and accuracy. The results of our experiments demonstrate that the proposed multitask prediction model achieved high accuracy and good balance in predicting all five post-transplant risk factors, with a maximum accuracy discrepancy of only 2.7%. The fairness-achieving algorithm significantly reduced the fairness disparity compared to the baseline model.