PMID- 37767525
OWN - NLM
STAT- MEDLINE
DCOM- 20230929
LR  - 20231013
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Print)
IS  - 0934-0874 (Linking)
VI  - 36
DP  - 2023
TI  - A Multi-Step Precision Pathway for Predicting Allograft Survival in Heterogeneous 
      Cohorts of Kidney Transplant Recipients.
PG  - 11338
LID - 10.3389/ti.2023.11338 [doi]
LID - 11338
AB  - Accurate prediction of allograft survival after kidney transplantation allows 
      early identification of at-risk recipients for adverse outcomes and initiation of 
      preventive interventions to optimize post-transplant care. Many prediction 
      algorithms do not model cohort heterogeneity and may lead to inaccurate 
      assessment of longer-term graft outcomes among minority groups. Using data from a 
      national Australian kidney transplant cohort (2008-2017) as the derivation set, 
      we developed P-Cube, a multi-step precision prediction pathway model for 
      predicting overall graft survival in three ethnic subgroups: European 
      Australians, Asian Australians and Aboriginal and Torres Strait Islander Peoples. 
      The concordance index for the European Australians, Asian Australians, and 
      Aboriginal and Torres Strait Islander Peoples subpopulations were 0.99 
      (0.98-0.99), 0.93 (0.92-0.94) and 0.92 (0.91-0.93), respectively. Similar 
      findings were observed when validating P-cube using an external dataset 
      [Scientific Registry of Transplant Recipient Registry (2006-2020)]. Six 
      sub-categories of recipients with distinct risk factor profiles were identified. 
      Some factors such as blood group compatibility were considered important across 
      the entire transplant population. Other factors such as human leukocyte antigen 
      (HLA)-DR mismatches were unique to older recipients. The P-cube model identifies 
      allograft survival specific risk factors within a heterogenous population and 
      offers personalized survival predictions in a diverse cohort.
CI  - Copyright (c) 2023 Zhang, Deng, Muller, Wong and Yang.
FAU - Zhang, Yunwei
AU  - Zhang Y
AD  - Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
AD  - School of Mathematics and Statistics, The University of Sydney, Sydney, NSW, 
      Australia.
FAU - Deng, Danny
AU  - Deng D
AD  - Centre for Kidney Research, Kids Research Institute, The Children's Hospital at 
      Westmead, Sydney, NSW, Australia.
AD  - Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
FAU - Muller, Samuel
AU  - Muller S
AD  - School of Mathematics and Statistics, The University of Sydney, Sydney, NSW, 
      Australia.
AD  - School of Mathematical and Physical Sciences, Macquarie University, Sydney, NSW, 
      Australia.
FAU - Wong, Germaine
AU  - Wong G
AD  - Centre for Kidney Research, Kids Research Institute, The Children's Hospital at 
      Westmead, Sydney, NSW, Australia.
AD  - Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
AD  - Centre for Transplant and Renal Research, Westmead Hospital, Sydney, NSW, 
      Australia.
FAU - Yang, Jean Yee Hwa
AU  - Yang JYH
AD  - Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
AD  - School of Mathematics and Statistics, The University of Sydney, Sydney, NSW, 
      Australia.
AD  - Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, 
      China.
LA  - eng
PT  - Journal Article
DEP - 20230912
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
SB  - IM
MH  - Humans
MH  - *Kidney Transplantation/adverse effects
MH  - Transplant Recipients
MH  - Australia/epidemiology
MH  - Transplantation, Homologous
MH  - Allografts
PMC - PMC10520244
OTO - NOTNLM
OT  - ANZDATA
OT  - allograft survival prediction
OT  - kidney transplantation
OT  - kidney transplantation graft survival
OT  - prediction model
COIS- Author JY was employed by the company Laboratory of Data Discovery for Health 
      Limited (D24H). The remaining authors declare that the research was conducted in 
      the absence of any commercial or financial relationships that could be construed 
      as a potential conflict of interest.
EDAT- 2023/09/28 06:42
MHDA- 2023/09/29 06:44
PMCR- 2023/09/12
CRDT- 2023/09/28 04:17
PHST- 2023/03/05 00:00 [received]
PHST- 2023/08/29 00:00 [accepted]
PHST- 2023/09/29 06:44 [medline]
PHST- 2023/09/28 06:42 [pubmed]
PHST- 2023/09/28 04:17 [entrez]
PHST- 2023/09/12 00:00 [pmc-release]
AID - 11338 [pii]
AID - 10.3389/ti.2023.11338 [doi]
PST - epublish
SO  - Transpl Int. 2023 Sep 12;36:11338. doi: 10.3389/ti.2023.11338. eCollection 2023.