机构:[1]Kunming Med Univ, Affiliated Hosp 1, Dept Nephrol, Kunming, Peoples R China内科科室肾脏内科昆明医科大学附属第一医院[2]Kunming Med Univ, Affiliated Hosp 1, Organ Transplantat Ctr, Kunming, Peoples R China昆明医科大学附属第一医院
Background Kidney transplantation is the optimal form of renal replacement therapy, but the long-term survival rate of kidney graft has not improved significantly. Currently, no well-validated model exists for predicting long-term kidney graft survival over an extended observation period.Methods Recipients undergoing allograft kidney transplantation at the Organ Transplantation Center of the First Affiliated Hospital of Kunming Medical University from 1 August 2003 to 31 July 2023 were selected as study subjects. A nomogram model was constructed based on least absolute selection and shrinkage operator (LASSO) regression, random survival forest, and Cox regression analysis. Model performance was assessed by the C-index, area under the curve of the time-dependent receiver operating characteristic curve, and calibration curve. Decision curve analysis (DCA) was utilized to estimate the net clinical benefit.Results The machine learning-based nomogram included cardiovascular disease in recipients, delayed graft function in recipients, serum phosphorus in recipients, age of donors, serum creatinine in donors, and donation after cardiac death for kidney donation. It demonstrated excellent discrimination with a consistency index of 0.827. The calibration curves demonstrated that the model calibrated well. The DCA indicated a good clinical applicability of the model.Conclusion This study constructed a nomogram for predicting the 20-year survival rate of kidney graft after allograft kidney transplantation using six factors, which may help clinicians assess kidney transplant recipients individually and intervene.
基金:
This work was supported by a grant from Outstanding-Youth Cultivation Project for Union Foundation of Yunnan Applied Basic Research Projects (Project Number: 202201AY070001-044), Reserve Talents Project for Young and Middle-aged Academic and Technical Leaders of Yunnan Province (Project Number: 202205AC160062), 535 Talent Project of First Affiliated Hospital of Kunming Medical University (Project Number: 2022535D06), “ChengFeng” Talent Training Project for Young and Middle-aged Academic Leaders and Reserve Talents of Kunming Medical University, First-Class Discipline Team of Kunming Medical University (Project Number: 2024XKTDPY03), and Yunnan Key Laboratory of Organ Transplantation (Project Number: 202449CE340016).
第一作者机构:[1]Kunming Med Univ, Affiliated Hosp 1, Dept Nephrol, Kunming, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
He Jiamin,Liu Pinlin,Cao Lingyan,et al.A machine learning-based nomogram for predicting graft survival in allograft kidney transplant recipients: a 20-year follow-up study[J].FRONTIERS IN MEDICINE.2025,12:doi:10.3389/fmed.2025.1556374.
APA:
He, Jiamin,Liu, Pinlin,Cao, Lingyan,Su, Feng,Li, Yifei...&Fan, Wenxing.(2025).A machine learning-based nomogram for predicting graft survival in allograft kidney transplant recipients: a 20-year follow-up study.FRONTIERS IN MEDICINE,12,
MLA:
He, Jiamin,et al."A machine learning-based nomogram for predicting graft survival in allograft kidney transplant recipients: a 20-year follow-up study".FRONTIERS IN MEDICINE 12.(2025)