New models for donor-recipient matching in lung transplantations
| Autor: | Pedro Antonio Gutiérrez, S. Cárcel, C. J. C. Robles-Arista, A. Salvatierra-Velázquez, J. M. Dueñas-Jurado, A. Casado-Adam, F. Santos-Luna, César Hervás-Martínez |
|---|---|
| Přispěvatelé: | [Dueñas-Jurado,JM, Cárcel,S, Robles-Arista,CJC] Intensive Care Unit, Reina Sofia University Hospital, Cordoba, Spain. [Gutiérrez,PA, Hervás-Martínez,C] Department of Computer Science and Numerical Analysis, Universidad de Córdoba, Córdoba, Spain. [Casado-Adam,A] General and Digestive Surgery Unit, Reina Sofia University Hospital, Cordoba, Spain. [Santos-Luna,F] Pneumology and Lung Transplant Service, Reina Sofia University Hospital, Cordoba, Spain. [Salvatierra-Velázquez,A] Thoracic Surgery and Lung Transplantation Service, Reina Sofia University Hospital, Cordoba, Spain. [Cárcel,S] Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Cordoba, Spain., This study was funded by the Spanish Ministry of Economy and Competitiveness (MINECO), and FEDER funds (EU) to PAG and CHM (TIN2017-85887-C2-1-P and TIN2017- 90567-REDT). |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Vital capacity Critical Care and Emergency Medicine Traumatic Brain Injury medicine.medical_treatment Respiratory System 030204 cardiovascular system & hematology Concepción de donantes Vascular Medicine law.invention Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] 0302 clinical medicine law Persons::Persons::Tissue Donors [Medical Subject Headings] Ischemia Fraction of inspired oxygen Medicine and Health Sciences Respiratory System Procedures Trauma Medicine Multidisciplinary Graft Survival Tissue Donors Analytical Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures Operative::Transplantation::Organ Transplantation::Lung Transplantation [Medical Subject Headings] Survival Rate Chemistry Obtención de tejidos y órganos Donation Physical Sciences Lung transplantations Medicine Female Anatomy Donor Traumatic Injury Phenomena and Processes::Immune System Phenomena::Immune System Processes::Transplantation Immunology::Host vs Graft Reaction::Graft Survival [Medical Subject Headings] Research Article Lung Transplantation Chemical Elements medicine.medical_specialty Tissue and Organ Procurement Science Check Tags::Male [Medical Subject Headings] Surgical and Invasive Medical Procedures Health Care::Health Care Facilities Manpower and Services::Health Services::Tissue and Organ Procurement [Medical Subject Headings] 03 medical and health sciences FEV1/FVC ratio Trasplante de pulmón medicine Cardiopulmonary bypass Lung transplantation Humans Intensive care medicine Mechanical ventilation Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings] Transplantation Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Survival Rate [Medical Subject Headings] business.industry Biology and Life Sciences Organ Transplantation Receptores de trasplantes Transplant Recipients Oxygen 030228 respiratory system Check Tags::Female [Medical Subject Headings] Spain Trasplante Lungs business Neurotrauma |
| Zdroj: | PLoS ONE PLoS ONE, Vol 16, Iss 6, p e0252148 (2021) |
| ISSN: | 1932-6203 |
| Popis: | ObjectiveOne of the main problems of lung transplantation is the shortage of organs as well as reduced survival rates. In the absence of an international standardized model for lung donor-recipient allocation, we set out to develop such a model based on the characteristics of past experiences with lung donors and recipients with the aim of improving the outcomes of the entire transplantation process.MethodsThis was a retrospective analysis of 404 lung transplants carried out at the Reina Sofía University Hospital (Córdoba, Spain) over 23 years. We analyzed various clinical variables obtained via our experience of clinical practice in the donation and transplantation process. These were used to create various classification models, including classical statistical methods and also incorporating newer machine-learning approaches.ResultsThe proposed model represents a powerful tool for donor-recipient matching, which in this current work, exceeded the capacity of classical statistical methods. The variables that predicted an increase in the probability of survival were: higher pre-transplant and post-transplant functional vital capacity (FVC), lower pre-transplant carbon dioxide (PCO2) pressure, lower donor mechanical ventilation, and shorter ischemia time. The variables that negatively influenced transplant survival were low forced expiratory volume in the first second (FEV1) pre-transplant, lower arterial oxygen pressure (PaO2)/fraction of inspired oxygen (FiO2) ratio, bilobar transplant, elderly recipient and donor, donor-recipient graft disproportion requiring a surgical reduction (Tailor), type of combined transplant, need for cardiopulmonary bypass during the surgery, death of the donor due to head trauma, hospitalization status before surgery, and female and male recipient donor sex.ConclusionsThese results show the difficulty of the problem which required the introduction of other variables into the analysis. The combination of classical statistical methods and machine learning can support decision-making about the compatibility between donors and recipients. This helps to facilitate reliable prediction and to optimize the grafts for transplantation, thereby improving the transplanted patient survival rate. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|