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3. A machine learning model for prediction of 30-day primary graft failure after heart transplantation

Author

Linse, Björn, Ohlsson, Mattias, Stehlik, Joseph, Lund, Lars H., Andersson, Bodil, Nilsson, Johan, Linse, Björn, Ohlsson, Mattias, Stehlik, Joseph, Lund, Lars H., Andersson, Bodil, and Nilsson, Johan

Abstract

Background: Primary graft failure (PGF) remains the most common cause of short-term mortality after heart transplantation. The main objective was to develop and validate a risk model for prediction of short-term mortality due to PGF after heart transplantation using the ISHLT Heart Transplant Registry. Methods: We developed a non-linear artificial neural networks (ANN) model to evaluate the association between recipient-donor variables and post-transplant PGF. Patients in the ISHLT registry were randomly divided into derivation and an independent internal validation cohort. The primary endpoint was PGF defined as death within 30 days due to Graft failure or Cardiovascular causes or retransplant within 30 days for causes other than rejection. Results: Among 64,964 adult recipients transplanted between 1994 and 2013, mean age was 51 years and 22% were female. The incidence of PGF up to 30 days was 3.7%. The ANN model selected 33 of 77 risk variables as relevant for PGF prediction. The C-index in the test cohort was 0.70 (95% CI: 0.68-0.71). The risk variables which most influenced the PGF were underlying HF diagnosis, ischemia time and sex, while renal function had a lower influence. Conclusion: An ANN model to predict primary graft dysfunction was derived and independently validated. The good discrimination of the ANN model likely results from its flexibility to model potentially non-linear relationships and interactions. Whether this model with improved discrimination can assist in clinical decisions at the time of transplant should be tested. © 2023 The Authors, The study was supported by the Swedish Research Council (2019-00487), Vinnova (2017-04689), Swedish Heart-Lung Foundation (20190623), a government grant for clinical research, region Skane research funds, donation funds from Skane University Hospital, and the Anna-Lisa and Sven Eric Lundgrens Foundation. The supporting sources had no involvement in the study.

Published
2023
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6. Abstract 540: Correlation of Improved Cholesterol Efflux Capacity of High Density Lipoprotein With Survival and Allograft Vasculopathy in Cardiac Transplant Recipients

Author

Javaheri, Ali, primary, Zamani, Payman, additional, Molina, Maria, additional, Rodrigues, Amrith, additional, Chambers, Susan, additional, Stutman, Patricia, additional, Maslanek, Wilhelmina, additional, Williams, Mary, additional, Lukmanova, Daniya, additional, Picataggi, Antonino, additional, Lilly, Scott, additional, Heeger, Peter S, additional, Sayegh, Mohamed H, additional, Chandraker, Anil K, additional, Sarling, Randall C, additional, Briscoe, David M, additional, Daly, Kevin P, additional, Stehlik, Joseph, additional, Ikle, David, additional, Christie, Jason, additional, Woo, Y. Joseph, additional, Goldberg, Lee R, additional, Billheimer, Jeffrey, additional, and Rader, Daniel J, additional

Published
2015
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8. Determinants of Waiting List Time for Heart Transplantation: Is It All About Sensitization?

Author

McCubrey, Raymond O., primary, Alharethi, Rami A., additional, Horne, Benjamin D., additional, Stehlik, Joseph, additional, Reid, Bruce, additional, Everitt, Melaine, additional, Drakos, Stavros D., additional, Budge, Deborah, additional, Nativi-Nicolau, Jose, additional, Nixon, Jennifer L., additional, Fang, James, additional, Caine, William, additional, and Kfoury, Abdallah G., additional

Published
2014
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9. Late Antibody-Mediated Rejection (AMR) in Heart Transplantation: How “Late” Is It?

Author

Nixon, Jennifer L., primary, Snow, Gregory L., additional, Budge, Deborah, additional, Hammond, M.E., additional, Stehlik, Joseph, additional, Reid, Bruce, additional, Alharethi, Rami A., additional, Miller, Dylan V., additional, Everitt, Melanie D., additional, McKellar, Stephen H., additional, Revelo, M.P., additional, Fang, James C., additional, and Kfoury, Abdallah G., additional

Published
2014
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12. Moving beyond "bridges".

Author

Fang JC and Stehlik J

Subjects
Female, Humans, Male, Heart-Assist Devices, Prosthesis Implantation methods, Prosthesis Implantation trends
Published
2013
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