Development and validation of primary graft dysfunction predictive algorithm for lung transplant candidates
Copyright © 2023 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Primary graft dysfunction (PGD) is the leading cause of early morbidity and mortality after lung transplantation. Accurate prediction of PGD risk could inform donor approaches and perioperative care planning. We sought to develop a clinically useful, generalizable PGD prediction model to aid in transplant decision-making.
METHODS: We derived a predictive model in a prospective cohort study of subjects from 2012 to 2018, followed by a single-center external validation. We used regularized (lasso) logistic regression to evaluate the predictive ability of clinically available PGD predictors and developed a user interface for clinical application. Using decision curve analysis, we quantified the net benefit of the model across a range of PGD risk thresholds and assessed model calibration and discrimination.
RESULTS: The PGD predictive model included distance from donor hospital to recipient transplant center, recipient age, predicted total lung capacity, lung allocation score (LAS), body mass index, pulmonary artery mean pressure, sex, and indication for transplant; donor age, sex, mechanism of death, and donor smoking status; and interaction terms for LAS and donor distance. The interface allows for real-time assessment of PGD risk for any donor/recipient combination. The model offers decision-making net benefit in the PGD risk range of 10% to 75% in the derivation centers and 2% to 10% in the validation cohort, a range incorporating the incidence in that cohort.
CONCLUSION: We developed a clinically useful PGD predictive algorithm across a range of PGD risk thresholds to support transplant decision-making, posttransplant care, and enrich samples for PGD treatment trials.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
|---|---|
| Enthalten in: |
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation - 43(2024), 4 vom: 08. März, Seite 633-641 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Diamond, Joshua M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Donor |
|---|
| Anmerkungen: |
Date Completed 18.03.2024 Date Revised 20.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.healun.2023.11.019 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM365560731 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM365560731 | ||
| 003 | DE-627 | ||
| 005 | 20240320233741.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.healun.2023.11.019 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1337.xml |
| 035 | |a (DE-627)NLM365560731 | ||
| 035 | |a (NLM)38065239 | ||
| 035 | |a (PII)S1053-2498(23)02157-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Diamond, Joshua M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Development and validation of primary graft dysfunction predictive algorithm for lung transplant candidates |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 18.03.2024 | ||
| 500 | |a Date Revised 20.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Primary graft dysfunction (PGD) is the leading cause of early morbidity and mortality after lung transplantation. Accurate prediction of PGD risk could inform donor approaches and perioperative care planning. We sought to develop a clinically useful, generalizable PGD prediction model to aid in transplant decision-making | ||
| 520 | |a METHODS: We derived a predictive model in a prospective cohort study of subjects from 2012 to 2018, followed by a single-center external validation. We used regularized (lasso) logistic regression to evaluate the predictive ability of clinically available PGD predictors and developed a user interface for clinical application. Using decision curve analysis, we quantified the net benefit of the model across a range of PGD risk thresholds and assessed model calibration and discrimination | ||
| 520 | |a RESULTS: The PGD predictive model included distance from donor hospital to recipient transplant center, recipient age, predicted total lung capacity, lung allocation score (LAS), body mass index, pulmonary artery mean pressure, sex, and indication for transplant; donor age, sex, mechanism of death, and donor smoking status; and interaction terms for LAS and donor distance. The interface allows for real-time assessment of PGD risk for any donor/recipient combination. The model offers decision-making net benefit in the PGD risk range of 10% to 75% in the derivation centers and 2% to 10% in the validation cohort, a range incorporating the incidence in that cohort | ||
| 520 | |a CONCLUSION: We developed a clinically useful PGD predictive algorithm across a range of PGD risk thresholds to support transplant decision-making, posttransplant care, and enrich samples for PGD treatment trials | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a donor | |
| 650 | 4 | |a lung transplantation | |
| 650 | 4 | |a prediction | |
| 650 | 4 | |a primary graft dysfunction | |
| 650 | 4 | |a recipient | |
| 700 | 1 | |a Anderson, Michaela R |e verfasserin |4 aut | |
| 700 | 1 | |a Cantu, Edward |e verfasserin |4 aut | |
| 700 | 1 | |a Clausen, Emily S |e verfasserin |4 aut | |
| 700 | 1 | |a Shashaty, Michael G S |e verfasserin |4 aut | |
| 700 | 1 | |a Kalman, Laurel |e verfasserin |4 aut | |
| 700 | 1 | |a Oyster, Michelle |e verfasserin |4 aut | |
| 700 | 1 | |a Crespo, Maria M |e verfasserin |4 aut | |
| 700 | 1 | |a Bermudez, Christian A |e verfasserin |4 aut | |
| 700 | 1 | |a Benvenuto, Luke |e verfasserin |4 aut | |
| 700 | 1 | |a Palmer, Scott M |e verfasserin |4 aut | |
| 700 | 1 | |a Snyder, Laurie D |e verfasserin |4 aut | |
| 700 | 1 | |a Hartwig, Matthew G |e verfasserin |4 aut | |
| 700 | 1 | |a Wille, Keith |e verfasserin |4 aut | |
| 700 | 1 | |a Hage, Chadi |e verfasserin |4 aut | |
| 700 | 1 | |a McDyer, John F |e verfasserin |4 aut | |
| 700 | 1 | |a Merlo, Christian A |e verfasserin |4 aut | |
| 700 | 1 | |a Shah, Pali D |e verfasserin |4 aut | |
| 700 | 1 | |a Orens, Jonathan B |e verfasserin |4 aut | |
| 700 | 1 | |a Dhillon, Ghundeep S |e verfasserin |4 aut | |
| 700 | 1 | |a Lama, Vibha N |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Mrunal G |e verfasserin |4 aut | |
| 700 | 1 | |a Singer, Jonathan P |e verfasserin |4 aut | |
| 700 | 1 | |a Hachem, Ramsey R |e verfasserin |4 aut | |
| 700 | 1 | |a Michelson, Andrew P |e verfasserin |4 aut | |
| 700 | 1 | |a Hsu, Jesse |e verfasserin |4 aut | |
| 700 | 1 | |a Russell Localio, A |e verfasserin |4 aut | |
| 700 | 1 | |a Christie, Jason D |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation |d 1993 |g 43(2024), 4 vom: 08. März, Seite 633-641 |w (DE-627)NLM012612367 |x 1557-3117 |7 nnns |
| 773 | 1 | 8 | |g volume:43 |g year:2024 |g number:4 |g day:08 |g month:03 |g pages:633-641 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.healun.2023.11.019 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 43 |j 2024 |e 4 |b 08 |c 03 |h 633-641 | ||