Hemorrhagic Risk Scoring System in Cirrhotic Children – HRS²C²


Cliniques Universitaires Saint-Luc in Brussels, Belgium, is the clinical institution associated to the Medical School of Université catholique de Louvain – UCL. Its different departments are delivering cutting-edge medical care, while supporting numerous fundamental, translational and clinical research programmes.


Cirrhosis in children stems from a wide variety of causes, and requires pediatric transplant. While awaiting a transplant, cirrhotic young patients run the risk of gastrointestinal bleeding due to portal hypertension : this bleeding is known to be correlated with esophageal varices characteristics. In a retrospective study, three clinically relevant factors for the risk of bleeding had been identified from 83 patients suffering from biliary atresia ; based on these preliminary results, DNAlyics was requested to build a predictive model of esophageal varices bleeding risk. This model was validated in a prospective study with cirrhotic children waiting for a liver transplant.


The predictive model built and validated by DNAlytics proved suitable for prioritizing cirrotic children waiting for a liver transplant on the basis of the bleeding risk indicator. The model has an estimated predictive performance of 81.03% in balanced classification rate (average between specificity and sensitivity) ; its accuracy reaches 88.55%.

The model can easily be used in clinical practice, as it requires only 3 common clinical inputs. To that end, DNAlytics has embedded the model into a piece of software that can be accessed and operated from a web platform : this smart tool is available at www.hrs2c2.com and is routinely used  in Saint-Luc Pediatrics department.  


"Our department is delighted about this collaboration with the experts from DNAlytics. They showed a capability to deliver high-quality scientifc results leading to co-publications and at the same time, they materialized their model into a smart application that could support decision-making in clinical practice."

Prof. Xavier Stéphenne, MD
Pediatric gastro-enterology and hepatology dpt.(Prof. E. Sokal)
Cliniques Universitaires Saint-Luc 


Stephenne X., Bonnet N., Varma S., Helleputte T., Smets F., Veyckemans F., Eeckhoudt S., Hermans C., Sokal E., Evaluating risk of esophageal variceal bleed in children with cirrhosis and waitlisted for liver transplantation, Journal of Pediatric Gastroenterology and Nutrition (2016)

Stephenne X., Wanty C., Helleputte T., Smets F., Sokal E., Assessment of risk of bleeding from esophageal varices during management of biliary atresia in children, 63rd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD), Boston MA, USA, (2012)

Wanty C., Helleputte T., Smets F., Sokal EM., Stephenne X., Assessment of risk of bleeding from esophageal varices during management of biliary atresia in children, Journal of Pediatric Gastroenterology and Nutrition. December 20, 2012 (2012)

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