A machine-learning approach to human ex vivo lung perfusion predicts transplantation outcomes and promotes organ utilization.

Humans Perfusion Lung Transplantation Retrospective Studies Artificial Intelligence Lung / surgery Tissue Donors Machine Learning

Journal

Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555

Informations de publication

Date de publication:
09 08 2023
Historique:
received: 28 09 2022
accepted: 26 07 2023
medline: 11 8 2023
pubmed: 10 8 2023
entrez: 9 8 2023
Statut: epublish

Résumé

Ex vivo lung perfusion (EVLP) is a data-intensive platform used for the assessment of isolated lungs outside the body for transplantation; however, the integration of artificial intelligence to rapidly interpret the large constellation of clinical data generated during ex vivo assessment remains an unmet need. We developed a machine-learning model, termed InsighTx, to predict post-transplant outcomes using n = 725 EVLP cases. InsighTx model AUROC (area under the receiver operating characteristic curve) was 79 ± 3%, 75 ± 4%, and 85 ± 3% in training and independent test datasets, respectively. Excellent performance was observed in predicting unsuitable lungs for transplantation (AUROC: 90 ± 4%) and transplants with good outcomes (AUROC: 80 ± 4%). In a retrospective and blinded implementation study by EVLP specialists at our institution, InsighTx increased the likelihood of transplanting suitable donor lungs [odds ratio=13; 95% CI:4-45] and decreased the likelihood of transplanting unsuitable donor lungs [odds ratio=0.4; 95%CI:0.16-0.98]. Herein, we provide strong rationale for the adoption of machine-learning algorithms to optimize EVLP assessments and show that InsighTx could potentially lead to a safe increase in transplantation rates.

Identifiants

DOI: 10.1038/s41467-023-40468-7 PMID: 37558674 PMC: PMC10412608
pubmed: 37558674
doi: 10.1038/s41467-023-40468-7
pii: 10.1038/s41467-023-40468-7
pmc: PMC10412608
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

4810

Informations de copyright

© 2023. Springer Nature Limited.

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Auteurs

Andrew T Sage (AT)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.
Department of Surgery, University of Toronto, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
ORCID: 0000-0003-2517-9062

Laura L Donahoe (LL)

Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.
Department of Surgery, University of Toronto, Toronto, ON, Canada.

Alaa A Shamandy (AA)

Department of Computer Science, University of Toronto, Toronto, ON, Canada.
Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.

S Hossein Mousavi (SH)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.
ORCID: 0000-0002-4891-3138

Bonnie T Chao (BT)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.

Xuanzi Zhou (X)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.

Jerome Valero (J)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.

Sharaniyaa Balachandran (S)

Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.

Aadil Ali (A)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.

Tereza Martinu (T)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.

George Tomlinson (G)

Department of Medicine, University Health Network, Toronto, ON, Canada.

Lorenzo Del Sorbo (L)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Interdepartmental Division of Critical Care Medicine, Medical and Surgical Intensive Care Unit, University Health Network, Toronto, ON, Canada.

Jonathan C Yeung (JC)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.
Department of Surgery, University of Toronto, Toronto, ON, Canada.
ORCID: 0000-0001-5759-3028

Mingyao Liu (M)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.
Department of Surgery, University of Toronto, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.

Marcelo Cypel (M)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.
Department of Surgery, University of Toronto, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
ORCID: 0000-0001-5652-1938

Bo Wang (B)

Department of Computer Science, University of Toronto, Toronto, ON, Canada. bo.wang@uhnresearch.ca.
Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada. bo.wang@uhnresearch.ca.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. bo.wang@uhnresearch.ca.
Vector Institute, Toronto, ON, Canada. bo.wang@uhnresearch.ca.

Shaf Keshavjee (S)

Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. shaf.keshavjee@uhn.ca.
Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada. shaf.keshavjee@uhn.ca.
Department of Surgery, University of Toronto, Toronto, ON, Canada. shaf.keshavjee@uhn.ca.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada. shaf.keshavjee@uhn.ca.
ORCID: 0000-0003-4547-8094

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A machine-learning approach to human ex vivo...
questionsmedicales.fr › Techniques d'investigation › Perfusion › A machine-learning approach to human ex vivo...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation d'organe › Transplantation pulmonaire › A machine-learning approach to human ex vivo...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › A machine-learning approach to human ex vivo...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Algorithmes › Intelligence artificielle › A machine-learning approach to human ex vivo...
questionsmedicales.fr › Appareil respiratoire › Poumon › A machine-learning approach to human ex vivo...
questionsmedicales.fr › Personnes › Donneurs de tissus › A machine-learning approach to human ex vivo...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Algorithmes › Intelligence artificielle › Apprentissage machine › A machine-learning approach to human ex vivo...