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Record W1707281389 · doi:10.5489/cuaj.1147

Prediction of delayed graft function after renal transplantation

2013· article· en· W1707281389 on OpenAlexaffvenue
Claudio Jeldres, Héloïse Cardinal, Alain Duclos, Shahrokh F. Shariat, Nazareno Suardi, Umberto Capitanio, Marie-Josèe Hébert, Pierre I. Karakiewicz

Bibliographic record

VenueCanadian Urological Association Journal · 2013
Typearticle
Languageen
FieldMedicine
TopicRenal Transplantation Outcomes and Treatments
Canadian institutionsUniversité de MontréalMcGill University Health Centre
Fundersnot available
KeywordsNomogramMedicineLogistic regressionTransplantationPanel reactive antibodyRenal transplantRenal functionDialysisKidney transplantationInternal medicineHemodialysisUrologySurgery

Abstract

fetched live from OpenAlex

Introduction: Delayed graft function (DGF), defined as the needfor dialysis during the first week after renal transplantation, is animportant adverse clinical outcome. A previous model relied on16 variables to quantify the risk of DGF, thereby undermining itsclinical usefulness. We explored the possibility of developing asimpler, equally accurate and more user-friendly paradigm forrenal transplant recipients from deceased donors.Methods: Logistic regression analyses addressed the occurrenceof DGF in 532 renal transplant recipients from deceased donors.Predictors consisted of recipient age, gender, race, weight, numberof HLA-A, HLA-B and HLA-DR mismatches, maximum andlast titre of panel reactive antibodies, donor age and cold ischemiatime. Accuracy was quantified with the area under the curve. Twohundred bootstrap resamples were used for internal validation.Results: Delayed graft function occurred in 103 patients (19.4%).Recipient weight (p < 0.001), panel of reactive antibodies (p < 0.001),donor age (p < 0.001), cold ischemia time (p = 0.005) and HLADRmismatches (p = 0.05) represented independent predictors.The multivariable nomogram relying on 6 predictors was 74.3%accurate in predicting the probability of DGF.Conclusion: Our simple and user-friendly model requires 6 variablesand is at least equally accurate (74%) to the previous nomogram(71%). We demonstrate that DGF can be accurately predictedin different populations with this new model.Introduction : La reprise retardée de la fonction (RRF) du greffon,définie comme le besoin de recourir à la dialyse pendant la premièresemaine suivant une transplantation rénale, est une issueclinique indésirable importante. Un modèle proposé antérieurementreposait sur 16 variables pour quantifier le risque de RRF,diminuant ainsi son utilité clinique. Nous avons exploré la possibilitéd’élaborer un paradigme simplifié et plus convivial tout enétant tout aussi précis pour les receveurs de greffons rénauxprovenant de donneurs décédés.Méthodologie : À l’aide d’analyses de régression logistique, nousavons étudié la survenue de la RRF du greffon chez 532 receveursde greffons rénaux provenant de donneurs décédés. Les facteursde prédiction comprenaient l’âge, le sexe, la race et le poids dureceveur et le nombre de non-concordance des phénotypes HLAA,HLA-B et HLA-DR, le titre maximal et le dernier titre d’anticorpsréactifs, l’âge du donneur et la période d’ischémie froide. L’exactitudea été quantifiée par la mesure de la surface sous la courbe. Deuxcents rééchantillonnages par auto-amorçage ont servi à la validationinterne.Résultats : Une reprise retardée de la fonction a été observée chez103 patients (19,4 %). Le poids du receveur (p < 0,001), les anticorpsréactifs (p < 0,001), l’âge du donneur (p < 0,001), la périoded’ischémie froide (p = 0,005) et la non-concordance des phénotypesHLA-DR (p = 0,05) constituaient des facteurs de prédictionindépendants. Le nomogramme multivarié reposant sur 6 facteursde prédiction a permis de prédire avec une exactitude de 74,3 %la probabilité de RRF.Conclusion : Notre modèle simple et convivial nécessite 6 va riableset est au moins tout aussi exact (74 %) que le nomogramme antérieur(71 %). La RRF peut être prévue avec exactitude dans différentespopulations à l’aide ce nouveau modèle, tel que nous en faisonsla démonstration.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.004
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.012
GPT teacher head0.212
Teacher spread0.199 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations56
Published2013
Admission routes2
Has abstractyes

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