(065) SURVIVAL AND GRAFT FAILURE FOLLOWING SOLID ORGAN TRANSPLANTATION IN HYPOGONADAL MEN: AN ANALYSIS OF THE INSTITUTE OF CLINICAL EVALUATIVE SCIENCES DATA REPOSITORY
Notice bibliographique
Résumé
Abstract Introduction Organ-specific mechanisms for hypogonadism have been reported in end-stage renal disease and cirrhosis. The most commonly transplanted organs in the United States are kidneys, hearts, livers, and lungs. Amongst kidney transplant recipients, worse survival has been reported amongst hypogonadal men. Aberration within grafted organs, whether failure, impaired function, or rejection, has also been reported in hypogonadal men undergoing renal, hepatic, and cardiac transplantation. Objective To determine if survival and time to graft failure amongst men undergoing solid organ transplantation differ based on pre-transplant testosterone levels. Methods The Institute for Clinical Evaluative Sciences (ICES) data repository (Ontario, Canada) was utilized in this study. Males aged ≥18 who underwent a solid organ transplant (SOT - heart, lung, kidney, liver) between 2009 and 2021 with at least one laboratory measurement of total testosterone within the three years before transplant were included in our study. A low testosterone (<300 ng/dL) and normal testosterone (≥300 ng/dL) cohort were created based on the pre-transplant total testosterone level closest to the time of transplant. Propensity score matching based on covariates in Table 1 was performed. One-to-one greedy nearest-neighbor matching was used to match individuals in the low and normal testosterone cohorts. Kaplan Meier curves and Cox proportional hazard models were used to assess survival following SOT. Aalen-Johansen cumulative incidence functions and Fine-Gray proportional hazard models with death as a competing risk was used to assess time to graft failure. We also assessed survival and graft failure in a kidney transplant-only cohort. Data are reported as hazard ratios (HR) or subdistribution hazard ratios (sHR) and 95% confidence interval. Survival ((log) hazard of death) following transplant was also assessed when pre-transplant testosterone was treated as a continuous variable modeled via a p-spline with 5 degrees of freedom. Our reference value was 300 ng/dL. All analyses were conducted within the ICES secure system (IDAVE) with R (version 4.2.2) and made use of the MatchIt (v4.5.5) and survival (v3.5.5) packages. Results We identified 121 men and 220 men having undergone solid-organ transplantation with low and normal testosterone, respectively. Baseline characteristics did not differ between cohorts following propensity score matching (Table 1). Survival (overall SOT HR 0.809, 0.494, 1.325; renal-only HR 1.263, 0.563,2.830) and graft failure (overall SOT sHR 0.834, 0.255, 2.7225; renal-only sHR 4.349, 0.538, 25.150) did not differ based on pre-transplant testosterone level in the either cohort. No clear relationship between pre-transplant testosterone level treated as a continuous variable and post-transplant survival was observed (Fig. 1). Conclusions Using the ICES data repository, post-transplant survival and graft survival did not differ significantly between hypogonadal and eugonadal men within our entire SOT (heart, lung, kidney, liver) or renal-only cohorts. A clear relationship between pre-transplant testosterone levels and survival was not identified. Future research is needed to elucidate pre-transplant testosterone trends and outcome data to highlight potential avenues for intervention with testosterone therapy or alternative modalities. Disclosure No.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,004 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».