Artificial intelligence assisted risk prediction in organ transplantation: a UK Live-Donor Kidney Transplant Outcome Prediction tool
Introduction: Predicting the outcome of a kidney transplant involving a living donor advances donor decision-making donors for clinicians and patients. However, the discriminative or calibration capacity of the currently employed models are limited. We set out to apply artificial intelligence (AI) a...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2431147 |
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| Summary: | Introduction: Predicting the outcome of a kidney transplant involving a living donor advances donor decision-making donors for clinicians and patients. However, the discriminative or calibration capacity of the currently employed models are limited. We set out to apply artificial intelligence (AI) algorithms to create a highly predictive risk stratification indicator, applicable to the UK’s transplant selection process.Methodology: Pre-transplant characteristics from 12,661 live-donor kidney transplants (performed between 2007 and 2022) from the United Kingdom Transplant Registry database were analyzed. The transplants were randomly divided into training (70%) and validation (30%) sets. Death-censored graft survival was the primary performance indicator. We experimented with four machine learning (ML) models assessed for calibration and discrimination [integrated Brier score (IBS) and Harrell’s concordance index]. We assessed the potential clinical utility using decision curve analysis.Results: XGBoost demonstrated the best discriminative performance for survival (area under the curve = 0.73, 0.74, and 0.75 at 3, 7, and 10 years post-transplant, respectively). The concordance index was 0.72. The calibration process was adequate, as evidenced by the IBS score of 0.09.Conclusion: By evaluating possible donor–recipient pairs based on graft survival, the AI-based UK Live-Donor Kidney Transplant Outcome Prediction has the potential to enhance choices for the best live-donor selection. This methodology may improve the outcomes of kidney paired exchange schemes. In general terms we show how the new AI and ML tools can have a role in developing effective and equitable healthcare. |
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| ISSN: | 0886-022X 1525-6049 |