Machine Learning Model to Predict Graft Rejection After Kidney Transplantation.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 26 03 2023
revised: 07 06 2023
accepted: 04 07 2023
medline: 27 11 2023
pubmed: 21 9 2023
entrez: 20 9 2023
Statut: ppublish

Résumé

There are few predictive studies about early posttransplant outcomes taking into account baseline and posttransplant variables. The objective of this study was to create a predictive model for 30-day graft rejection using machine learning techniques. Retrospective study with 1255 patients undergoing transplant from living and deceased donors at a tertiary health service in Brazil. Recipient, donor, transplantation, and postoperative period data were collected from physical and electronic records. We split the data into derivation (training) and validation (test) datasets. Five supervised machine learning algorithms were developed with this subset of variables in the training set: Simple Logistic Regression, Lasso, Multilayer Perceptron, XGBoost, and Light GBM. There were 147 (12.48%) cases of graft rejection within 30 days of transplantation. The best model was XGBoost (accuracy, 0.839; receiver operating characteristic area under the curve, 0.715; precision, 0.900). The model showed that deceased donor transplantation, glomerulopathy as an underlying disease, and donor's use of vasoactive drugs had more than 20% importance as rejection risk factors. The variables with the greatest predictive values were thymoglobulin induction and delayed graft function. We fitted a machine learning model to predict 30-day graft rejection after kidney transplantation that reaches a higher accuracy and precision. Machine learning models could contribute to predicting kidney survival using nontraditional approaches.

Sections du résumé

BACKGROUND BACKGROUND
There are few predictive studies about early posttransplant outcomes taking into account baseline and posttransplant variables. The objective of this study was to create a predictive model for 30-day graft rejection using machine learning techniques.
METHODS METHODS
Retrospective study with 1255 patients undergoing transplant from living and deceased donors at a tertiary health service in Brazil. Recipient, donor, transplantation, and postoperative period data were collected from physical and electronic records. We split the data into derivation (training) and validation (test) datasets. Five supervised machine learning algorithms were developed with this subset of variables in the training set: Simple Logistic Regression, Lasso, Multilayer Perceptron, XGBoost, and Light GBM.
RESULTS RESULTS
There were 147 (12.48%) cases of graft rejection within 30 days of transplantation. The best model was XGBoost (accuracy, 0.839; receiver operating characteristic area under the curve, 0.715; precision, 0.900). The model showed that deceased donor transplantation, glomerulopathy as an underlying disease, and donor's use of vasoactive drugs had more than 20% importance as rejection risk factors. The variables with the greatest predictive values were thymoglobulin induction and delayed graft function.
CONCLUSIONS CONCLUSIONS
We fitted a machine learning model to predict 30-day graft rejection after kidney transplantation that reaches a higher accuracy and precision. Machine learning models could contribute to predicting kidney survival using nontraditional approaches.

Identifiants

pubmed: 37730451
pii: S0041-1345(23)00558-4
doi: 10.1016/j.transproceed.2023.07.021
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2058-2062

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare no conflict of interest

Auteurs

Arthur Cesar Dos Santos Minato (ACDS)

Department of Internal Medicine, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Botucatu, Brazil. Electronic address: arthur.minato@unesp.br.

Pedro Guilherme Coelho Hannun (PGC)

Department of Internal Medicine, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Botucatu, Brazil.

Abner Macola Pacheco Barbosa (AMP)

Department of Internal Medicine, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Botucatu, Brazil.

Naila Camila da Rocha (NC)

Department of Internal Medicine, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Botucatu, Brazil.

Juliana Machado-Rugolo (J)

Health Technology Assessment Center (NATS), Clinical Hospital of Botucatu Medical School (HCFMB), São Paulo State University (UNESP), Botucatu, Brazil.

Marilia Mastrocolla de Almeida Cardoso (MMA)

Department of Internal Medicine, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Botucatu, Brazil; Health Technology Assessment Center (NATS), Clinical Hospital of Botucatu Medical School (HCFMB), São Paulo State University (UNESP), Botucatu, Brazil.

Luis Gustavo Modelli de Andrade (LGM)

Department of Internal Medicine, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Botucatu, Brazil.

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