Benchmarking Waitlist Mortality Prediction in Heart Transplantation Through Time-to-Event Modeling using New Longitudinal UNOS Dataset

Fuente: arXiv
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Autores principales: Luo, Yingtao, Skandari, Reza, Martinez, Carlos, Kilic, Arman, Padman, Rema
Formato: Preprint
Publicado: 2025
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author Luo, Yingtao
Skandari, Reza
Martinez, Carlos
Kilic, Arman
Padman, Rema
author_facet Luo, Yingtao
Skandari, Reza
Martinez, Carlos
Kilic, Arman
Padman, Rema
contents Decisions about managing patients on the heart transplant waitlist are currently made by committees of doctors who consider multiple factors, but the process remains largely ad-hoc. With the growing volume of longitudinal patient, donor, and organ data collected by the United Network for Organ Sharing (UNOS) since 2018, there is increasing interest in analytical approaches to support clinical decision-making at the time of organ availability. In this study, we benchmark machine learning models that leverage longitudinal waitlist history data for time-dependent, time-to-event modeling of waitlist mortality. We train on 23,807 patient records with 77 variables and evaluate both survival prediction and discrimination at a 1-year horizon. Our best model achieves a C-Index of 0.94 and AUROC of 0.89, significantly outperforming previous models. Key predictors align with known risk factors while also revealing novel associations. Our findings can support urgency assessment and policy refinement in heart transplant decision making.
format Preprint
id arxiv_https___arxiv_org_abs_2507_07339
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Benchmarking Waitlist Mortality Prediction in Heart Transplantation Through Time-to-Event Modeling using New Longitudinal UNOS Dataset
Luo, Yingtao
Skandari, Reza
Martinez, Carlos
Kilic, Arman
Padman, Rema
Applications
Machine Learning
Decisions about managing patients on the heart transplant waitlist are currently made by committees of doctors who consider multiple factors, but the process remains largely ad-hoc. With the growing volume of longitudinal patient, donor, and organ data collected by the United Network for Organ Sharing (UNOS) since 2018, there is increasing interest in analytical approaches to support clinical decision-making at the time of organ availability. In this study, we benchmark machine learning models that leverage longitudinal waitlist history data for time-dependent, time-to-event modeling of waitlist mortality. We train on 23,807 patient records with 77 variables and evaluate both survival prediction and discrimination at a 1-year horizon. Our best model achieves a C-Index of 0.94 and AUROC of 0.89, significantly outperforming previous models. Key predictors align with known risk factors while also revealing novel associations. Our findings can support urgency assessment and policy refinement in heart transplant decision making.
title Benchmarking Waitlist Mortality Prediction in Heart Transplantation Through Time-to-Event Modeling using New Longitudinal UNOS Dataset
topic Applications
Machine Learning
url https://arxiv.org/abs/2507.07339