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- W2040384811 abstract "Although survival after cardiac transplantation has been improved in the last decades, primary graft dysfunction (PGD) remains the most common cause of short-term mortality. The main objective of this study was to develop and validate a risk model for prediction of short-term mortality due to PGD after heart transplantation using the ISHLT Heart Transplant Registry. We developed a non-linear artificial neural networks (ANN) model to evaluate the impact of recipient-donor variables on post-transplant PGD. The patients, whose data were obtained from the ISHLT registry, were randomly divided into derivation and an independent internal validation cohort. The primary endpoint was death due to primary graft failure, technical failure, hyper-acute or acute rejection within 90 days post-transplant. The study group consisted of 48,332 adult recipients transplanted between 1994 and 2010. Mean age was 51 years and 21% were female. The incidence of PGD up to 90 days was 2.8%. The ANN model selected 33 of 77 risk variables as relevant for PGD prediction. The C-index in the derivation cohort was 0.70 (95% CI: 0.68-0.71) and did not differ from the validation cohorts, p=0.228. The Hosmer-Lemeshow p value for derivation cohort was 0.676, indicating good accuracy. The risk variables which most influenced the discrimination were the era of transplantation, previous cardiac surgery, body size, donor age, duration of ischemia, urgency, and panel reactive antibody. A Web-based calculator (http://aictsgrid.thep.lu.se/ihtsa/ihtsa2.pl) was implemented as an interactive web-application (web screen shot in Figure). An ANN model to predict primary graft dysfunction was derived with strong discriminatiom and independently validated. The strength of the ANN model is its flexibility to model potentially non-linear relationships and interactions in a virtual fashion. Such model can be used as a virtual recipient-donor matching tool that models survival for potential recipients when a donor heart becomes available." @default.
- W2040384811 created "2016-06-24" @default.
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- W2040384811 date "2015-04-01" @default.
- W2040384811 modified "2023-10-02" @default.
- W2040384811 title "Prediction of Primary Graft Dysfunction After Heart Transplantation" @default.
- W2040384811 doi "https://doi.org/10.1016/j.healun.2015.01.083" @default.
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