Saturday, March 23, 2024

Kidney biopsies can be predicted pretty well, which could speed organ allocation

 Here's a big international collaboration suggesting that AI assisted predictions about kidney biopsies are effective, and could speed acceptance of deceased donor organs for transplant.

 "A Machine Learning-Driven Virtual Biopsy System For Kidney Transplant Patients." Nature Communications 15, no. 1 (2024): 554.  by Daniel Yoo, Gillian Divard, Marc Raynaud, Aaron Cohen, Tom D. Mone, John Thomas Rosenthal, Andrew J. Bentall, Mark D. Stegall, Maarten Naesens, Huanxi Zhang, Changxi Wang, Juliette Gueguen, Nassim Kamar, Antoine Bouquegneau, Ibrahim Batal, Shana M. Coley, John S. Gill, Federico Oppenheimer, Erika De Sousa-Amorim, Dirk R. J. Kuypers, Antoine Durrbach, Daniel Seron, Marion Rabant, Jean-Paul Duong Van Huyen, Patricia Campbell, Soroush Shojai, Michael Mengel, Oriol Bestard, Nikolina Basic-Jukic, Ivana Jurić, Peter Boor, Lynn D. Cornell, Mariam P. Alexander, P. Toby Coates, Christophe Legendre, Peter P. Reese, Carmen Lefaucheur, Olivier Aubert & Alexandre Loupy

From the discussion:

"In this international, multicohort study of kidney transplant biopsies from 17 worldwide centers including the largest Organ Procurement Organization (OPO) in the USA and labeled by expert kidney pathologists, we derived and validated a virtual biopsy system that uses non-invasive and routinely collected donor parameters to predict kidney histological lesions.

...

"Over the past decade, the use of kidneys from older donors with comorbidities has expanded the pool of kidneys, raising the question of whether pathological examination of donated kidneys could help better characterize organ quality or drive inefficiencies in organ allocation22. Additionally, this biopsy procedure needs to be performed and interpreted by trained experts, which is difficult to implement 24/7 . Furthermore, in the USA, the United Network for Organ Sharing policy for organ allocation, recommends the use of KDPI, day-zero biopsy results, and donor characteristics to assess organ quality before transplantation. Despite the importance, the lost time due to this procedure could be precious when the biopsy result is used for allocation purposes as every additional hour of cold ischemia time is highly associated with worse graft outcomes. Therefore, many centers are discouraged from performing day-zero biopsy because it remains an invasive and time-consuming procedure that could increase cold ischemia time."

 

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