Leveraging Machine Learning to Predict Delayed Graft Function Occurrence and Length in Kidney Transplant Recipients

Fuente: Wiley Open Access
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Auteurs principaux: Alexandru Nica, Mateo Velasquez Mejia, Ahmed Abdelrheem, Byron Smith, Walter Park, Mark Stegall, Raymond Heilman, Caroline Jadlowiec
Format: Artículo Open Access
Publié: Wiley 2026
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author Alexandru Nica
Mateo Velasquez Mejia
Ahmed Abdelrheem
Byron Smith
Walter Park
Mark Stegall
Raymond Heilman
Caroline Jadlowiec
author_facet Alexandru Nica
Mateo Velasquez Mejia
Ahmed Abdelrheem
Byron Smith
Walter Park
Mark Stegall
Raymond Heilman
Caroline Jadlowiec
Alexandru Nica
Mateo Velasquez Mejia
Ahmed Abdelrheem
Byron Smith
Walter Park
Mark Stegall
Raymond Heilman
Caroline Jadlowiec
collection Wiley Open Access
contents Leveraging Machine Learning to Predict Delayed Graft Function Occurrence and Length in Kidney Transplant Recipients Alexandru Nica Mateo Velasquez Mejia Ahmed Abdelrheem Byron Smith Walter Park Mark Stegall Raymond Heilman Caroline Jadlowiec Clinical Transplantation ABSTRACT Predicting delayed graft function (DGF) relies on donor, recipient, and perioperative factors. Despite the growing recognition that DGF duration strongly influences patient outcomes, no models currently address or predict its impact—highlighting an important gap in current research and clinical practice. This study aimed to develop an ensemble‐based machine learning model using perioperative data to predict DGF occurrence and duration. The gradient‐boosted decision trees model was trained and validated on 2725 patients, with k‐fold cross‐validation in an external cohort of 284 patients. Model performance was evaluated based on accuracy, ROC‐AUC, and other metrics using R and Python libraries. The binary DGF prediction model achieved a ROC‐AUC of 0.77, while the DGF duration classification model had an accuracy of 79.2%. DGF duration AUC values by time interval were 0.76 for 0–1 weeks, 0.81 for >1–2 weeks, 0.80 for >2–3 weeks, and 0.87 for >3 weeks; the overall macro‐averaged AUC was 0.81. The mean Brier score for multi‐class predictions was 0.14. External validation showed a 78% accuracy for DGF duration prediction. Acute kidney injury (AKI) and donor donation after circulatory death (DCD) status were key DGF predictors. The use of gradient‐boosted decision trees (GBDT) improves the prediction of both the likelihood and duration of DGF, addressing a current gap in kidney transplant patient care. By facilitating personalized transplant care, this model supports more effective perioperative planning and timely interventions, which may contribute to better patient outcomes. 10.1111/ctr.70514 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/ctr.70514
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institution Wiley Open Access
license_str_mv http://onlinelibrary.wiley.com/termsAndConditions#vor
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publisher Wiley
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spellingShingle Leveraging Machine Learning to Predict Delayed Graft Function Occurrence and Length in Kidney Transplant Recipients
Alexandru Nica
Mateo Velasquez Mejia
Ahmed Abdelrheem
Byron Smith
Walter Park
Mark Stegall
Raymond Heilman
Caroline Jadlowiec
Clinical Transplantation
Leveraging Machine Learning to Predict Delayed Graft Function Occurrence and Length in Kidney Transplant Recipients Alexandru Nica Mateo Velasquez Mejia Ahmed Abdelrheem Byron Smith Walter Park Mark Stegall Raymond Heilman Caroline Jadlowiec Clinical Transplantation ABSTRACT Predicting delayed graft function (DGF) relies on donor, recipient, and perioperative factors. Despite the growing recognition that DGF duration strongly influences patient outcomes, no models currently address or predict its impact—highlighting an important gap in current research and clinical practice. This study aimed to develop an ensemble‐based machine learning model using perioperative data to predict DGF occurrence and duration. The gradient‐boosted decision trees model was trained and validated on 2725 patients, with k‐fold cross‐validation in an external cohort of 284 patients. Model performance was evaluated based on accuracy, ROC‐AUC, and other metrics using R and Python libraries. The binary DGF prediction model achieved a ROC‐AUC of 0.77, while the DGF duration classification model had an accuracy of 79.2%. DGF duration AUC values by time interval were 0.76 for 0–1 weeks, 0.81 for >1–2 weeks, 0.80 for >2–3 weeks, and 0.87 for >3 weeks; the overall macro‐averaged AUC was 0.81. The mean Brier score for multi‐class predictions was 0.14. External validation showed a 78% accuracy for DGF duration prediction. Acute kidney injury (AKI) and donor donation after circulatory death (DCD) status were key DGF predictors. The use of gradient‐boosted decision trees (GBDT) improves the prediction of both the likelihood and duration of DGF, addressing a current gap in kidney transplant patient care. By facilitating personalized transplant care, this model supports more effective perioperative planning and timely interventions, which may contribute to better patient outcomes. 10.1111/ctr.70514 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Leveraging Machine Learning to Predict Delayed Graft Function Occurrence and Length in Kidney Transplant Recipients
topic Clinical Transplantation
url https://onlinelibrary.wiley.com/doi/10.1111/ctr.70514