American Journal of Transplantation最新文献_第10页

Using machine learning for personalized prediction of longitudinal coronavirus disease 2019 vaccine responses in transplant recipients. 利用机器学习个性化预测移植受者的纵向COVID-19疫苗反应

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-04 DOI: 10.1016/j.ajt.2024.11.033

Ghazal Azarfar, Yingji Sun, Elisa Pasini, Aman Sidhu, Michael Brudno, Atul Humar, Deepali Kumar, Mamatha Bhat, Victor H Ferreira

{"title":"Using machine learning for personalized prediction of longitudinal coronavirus disease 2019 vaccine responses in transplant recipients.","authors":"Ghazal Azarfar, Yingji Sun, Elisa Pasini, Aman Sidhu, Michael Brudno, Atul Humar, Deepali Kumar, Mamatha Bhat, Victor H Ferreira","doi":"10.1016/j.ajt.2024.11.033","DOIUrl":"10.1016/j.ajt.2024.11.033","url":null,"abstract":"The coronavirus disease 2019 pandemic has underscored the importance of vaccines, especially for immunocompromised populations like solid organ transplant recipients, who often have weaker immune responses. The purpose of this study was to compare deep learning architectures for predicting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine responses 12 months postvaccination in this high-risk group. Using data from 303 solid organ transplant recipients from a Canadian multicenter cohort, models were developed to forecast anti-receptor-binding domain antibody levels. The study compared traditional machine learning models-logistic regression, epsilon-support vector regression, random forest regressor, and gradient boosting regressor-and deep learning architectures, including long short-term memory (LSTM), recurrent neural networks, and a novel model, routed LSTM. This new model combines capsule networks with LSTM to reduce the need for large data sets. Demographic, clinical, and transplant-specific data, along with longitudinal antibody measurements, were incorporated into the models. The routed LSTM performed best, achieving a mean square error of 0.02 ± 0.02 and a Pearson correlation coefficient of 0.79 ± 0.24, outperforming all other models. Key factors influencing vaccine response included age, immunosuppression, breakthrough infection, body mass index, sex, and transplant type. These findings suggest that artificial intelligence could be a valuable tool in tailoring vaccine strategies, improving health outcomes for vulnerable transplant recipients.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term outcomes at 5 years posttransplant in imlifidase-desensitized kidney transplant patients. imlifidase脱敏肾移植患者移植后5年的长期预后。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-04 DOI: 10.1016/j.ajt.2024.11.029

Stanley C Jordan, Angela Q Maldonado, Bonnie E Lonze, Kristoffer Sjöholm, Anna Lagergren, Robert A Montgomery, Anna Runström, Niraj M Desai, Christophe Legendre, Torbjörn Lundgren, Bengt von Zur Mühlen, Ashley A Vo, Jan Tollemar, Paola Lefèvre, Tomas Lorant

引用次数: 0

Are we closer to abandoning protocol graft biopsies after pediatric liver transplantation? 我们离放弃儿童肝移植后的移植物活检更近了吗？

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-04 DOI: 10.1016/j.ajt.2024.11.028

Roberta Angelico, Josh Levitsky

引用次数: 0

Low risk of prolonged SARS-CoV-2 shedding and molecular evolution in kidney transplant recipients during the Omicron era: A prospective observational study. Omicron时代肾移植受者长期SARS-CoV-2脱落和分子进化的低风险：一项前瞻性观察研究

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-03 DOI: 10.1016/j.ajt.2024.11.031

Ivan Zahradka, Vojtech Petr, Jan Paces, Jana Zdychova, Alena Srbova, Radomira Limberkova, Timotej Suri, Filip Tichanek, Denisa Husakova, Helena Jirincova, Miluse Hradilova, Ilja Striz, Ondrej Viklicky

{"title":"Low risk of prolonged SARS-CoV-2 shedding and molecular evolution in kidney transplant recipients during the Omicron era: A prospective observational study.","authors":"Ivan Zahradka, Vojtech Petr, Jan Paces, Jana Zdychova, Alena Srbova, Radomira Limberkova, Timotej Suri, Filip Tichanek, Denisa Husakova, Helena Jirincova, Miluse Hradilova, Ilja Striz, Ondrej Viklicky","doi":"10.1016/j.ajt.2024.11.031","DOIUrl":"10.1016/j.ajt.2024.11.031","url":null,"abstract":"The aim of this prospective study was to assess the duration of culture-viable SARS-CoV-2 and to monitor the emergence of mutations in a cohort of 23 kidney transplant recipients (KTRs) from June 2022 to June 2023. Combined nares/oropharyngeal swabs were collected weekly starting as soon as possible after symptom onset. The time from symptom onset to a negative culture was 11 days (interquartile range, 8-14), while the time to negative reverse transcriptase quantitative polymerase chain reaction was 18 days (interquartile range, 15-30). Beyond the first swab, 21.7% had a positive culture, and 8.7% replicated viable virus for longer than 30 days. T cell depletion (rate ratio, 2.5; 95% confidence interval [95% CI], 1.9-3.3; P < .001) and time from transplantation (rate ratio, 0.93; 95% CI, 0.90-0.97; P = .006) were associated with the time of viable virus shedding. A cycle threshold value of 24.2 demonstrated a 91.3% negative predictive value of viability (95% credible interval [95% CrI], 76-100). The odds of viability decreased by 69% per week of infection (odds ratio, 0.31; 95% CrI, 0.12-0.76). Overall, ribonucleic acid sequencing did not show accelerated molecular evolution though mutation rate could be increased in molnupiravir-treated KTRs. In conclusion, viable SARS-CoV-2 is eliminated rapidly, the risk of virus evolution is low, and prolonged self-isolation is generally unnecessary for most KTRs.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Balancing equity and human leukocyte antigen matching in deceased-donor kidney allocation with eplet mismatch. 在Eplet配错的死亡供者肾脏分配中平衡公平和HLA匹配。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-02 DOI: 10.1016/j.ajt.2024.11.030

Michal A Mankowski, Loren Gragert, Brendan Keating, Bonnie E Lonze, Dorry L Segev, Robert Montgomery, Sommer E Gentry, Massimo Mangiola

{"title":"Balancing equity and human leukocyte antigen matching in deceased-donor kidney allocation with eplet mismatch.","authors":"Michal A Mankowski, Loren Gragert, Brendan Keating, Bonnie E Lonze, Dorry L Segev, Robert Montgomery, Sommer E Gentry, Massimo Mangiola","doi":"10.1016/j.ajt.2024.11.030","DOIUrl":"10.1016/j.ajt.2024.11.030","url":null,"abstract":"Human leukocyte antigen-level matching in US kidney allocation has been deemphasized due to its role in elevating racial disparities. Molecular matching based on eplets might improve risk stratification compared to antigen matching, but the magnitude of racial disparities in molecular matching is not known. To assign eplets unambiguously, we utilized a cohort of 5193 individuals with high-resolution allele-level human leukocyte antigen genotypes from the National Kidney Registry. Using repeated random sampling to simulate donor-recipient genotype pairings based on the ethnic composition of the historical US deceased-donor pool, we profiled the percentage of well-matched donors available for candidates by ethnicity. The prevalence of well-matched donors with 0-DR/DQ eplet mismatch was 3-fold less racially disparate for Black and Asian candidates and 2-fold less for Latino candidates compared to 0-ABDR antigen mismatches. Compared to 0-DR antigen mismatch, 0-DR eplet mismatch was 1.33-fold more racially disparate for Asian and 1.28-fold more for Latino, with similar disparity for Black candidates, whereas 0-DQ eplet mismatch reduced disparities, showing 1.26-fold less disparity for Black, 1.14-fold less for Latino, but 1.26-fold higher for Asian candidates. The prevalence of well-matched donors for candidates of different ethnicities varied according to which molecules were chosen to define a low-risk match.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142778683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The underreporting of liver machine perfusion in US national data. 美国国家数据中肝机灌注的低报。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-30 DOI: 10.1016/j.ajt.2024.11.027

Nicolas Muñoz, Emily Minus, Peter Abt, Elizabeth Sonnenberg

引用次数: 0

Pancreas transplant outcomes in patients with human immunodeficiency virus infection. 人类免疫缺陷病毒感染患者的胰腺移植结果。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-29 DOI: 10.1016/j.ajt.2024.11.023

Rashmi R Bharadwaj, Gabriel Orozco, Xiaonan Mei, Hanine El-Haddad, Roberto Gedaly, Meera Gupta

{"title":"Pancreas transplant outcomes in patients with human immunodeficiency virus infection.","authors":"Rashmi R Bharadwaj, Gabriel Orozco, Xiaonan Mei, Hanine El-Haddad, Roberto Gedaly, Meera Gupta","doi":"10.1016/j.ajt.2024.11.023","DOIUrl":"10.1016/j.ajt.2024.11.023","url":null,"abstract":"There is limited information on access and outcomes of patients living with human immunodeficiency virus (HIV) (PLWH) who have undergone pancreas transplantation. We conducted a retrospective cohort study analyzing data from the United Network for Organ Sharing from July 1, 2001, to June 30, 2021. Recipients of pancreas transplant were stratified by HIV serostatus. Graft and patient survival were analyzed using Kaplan-Meier product limit estimates. Multivariable Cox proportional hazard models were generated to identify factors associated with increased mortality or graft loss. Fifty PLWH and 16 380 patients without HIV underwent pancreas (with kidney) transplantation. PLWH were more often male (P < .001), Black/African American (P = .009), and on Medicare (P = .004). There were no significant differences in waiting time (P = .159) or proportion of patients treated for rejection within 1 year of transplant (P = .189) between groups. There were no differences in pancreas graft survival (P = .964) and overall patient survival (P = .250) between the cohorts. Dialysis status was negatively associated with graft survival. Although PLWH were more likely to represent a historically marginalized population, their outcomes after pancreas transplant were similar to their HIV-negative counterparts.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous donor-recipient age matching: A chance for kidney allocation in the Eurotransplant region. 连续供体-受体年龄匹配：在欧洲移植地区肾脏分配的机会。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-28 DOI: 10.1016/j.ajt.2024.11.022

Friedrich A von Samson-Himmelstjerna, Benedikt Kolbrink, Klemens Budde, Roland Schmitt, Kevin Schulte

引用次数: 0

Neural epidermal growth factor-like 1 protein-positive membranous nephropathy in renal allografts: A series of 6 patients. 6例同种异体肾移植患者的nell1阳性膜性肾病。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-28 DOI: 10.1016/j.ajt.2024.11.026

Anna Kenan, Anila Abraham Kurien, Manuel Gonzalez, Kyrstin Alexander, Anjushree Kumar, Ibrahim Qaqish, Tiffany Caza

引用次数: 0

Association of organ procurement organization volume with Centers for Medicare and Medicaid Services performance evaluations. 器官采购组织协会与CMS绩效评估卷。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-27 DOI: 10.1016/j.ajt.2024.11.024

Rocio Lopez, Sumit Mohan, James R Rodrigue, Susana Arrigain, Deena Brosi, Ryan Lavanchy, Bruce Kaplan, Elizabeth A Pomfret, Jesse D Schold

{"title":"Association of organ procurement organization volume with Centers for Medicare and Medicaid Services performance evaluations.","authors":"Rocio Lopez, Sumit Mohan, James R Rodrigue, Susana Arrigain, Deena Brosi, Ryan Lavanchy, Bruce Kaplan, Elizabeth A Pomfret, Jesse D Schold","doi":"10.1016/j.ajt.2024.11.024","DOIUrl":"10.1016/j.ajt.2024.11.024","url":null,"abstract":"Under 2020 Centers for Medicare and Medicaid Services (CMS) conditions of coverage, Organ Procurement Organizations (OPOs) will be decertified if their 95% upper confidence limit for donation or transplant rate falls below the previous year's median (tier 3) and must recompete if either is below the 75th percentile (tier 2). This study aimed to examine the associations of CMS metrics with OPO volume and evaluate an alternate observed-to-expected tiering system using simulation analysis and CMS's OPO public report. In 2021, CMS tier 3 and 2 OPOs had significantly larger volumes than tier 1 OPOs (median = 2042 vs 2124 vs 1003; P = .028). In a simulation scenario in which OPOs should be CMS tier 2, large OPOs had 95% probability of needing to recompete vs 26% for the smallest OPOs. The observed-to-expected method misclassified OPOs as underperforming ∼5% of simulated cases independent of volume. CMS methodology assigned a worse tier than observed-to-expected to 24%-54% of OPOs across years. Results indicate that the current CMS methodology systematically identifies larger OPOs as underperforming and independent of quality, suggesting alternative statistical evaluations are needed to assess OPO performance accurately and improve donation processes of care and transplant rates.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0