Journal article
GraftIQ: Hybrid multi-class neural network integrating clinical insight for multi-outcome prediction in liver transplant recipients
Nature communications, Vol.16(1), 4943
05/28/2025
DOI: 10.1038/s41467-025-59610-8
PMCID: PMC12120053
PMID: 40436838
Abstract
Liver transplant recipients (LTRs) are at risk of graft injury, leading to cirrhosis and reduced survival. Liver biopsy, the diagnostic gold standard, is invasive and risky. We developed a hybrid multi-class neural network (NN) model, 'GraftIQ,' integrating clinician expertise for non-invasive graft pathology diagnosis. Biopsies from LTRs (1992-2020) were classified into six categories using demographic, clinical, and lab data from 30 days pre-biopsy. The dataset (5217 biopsies) was split 70/30 for training/testing, with external validation at Mayo Clinic, Hannover Medical School, and NUHS Singapore. Bayesian fusion was used to combine clinician-derived probabilities with NN predictions, improving performance. Here we show that GraftIQ (MulticlassNN+clinical insight) achieved an AUC of 0.902 (95% CI:0.884-0.919), up from 0.885 with NN alone. Internal and external validation demonstrated 10-16% higher AUC than conventional ML models. GraftIQ demonstrates high accuracy in identifying graft etiologies and offers a valuable clinical decision support tool for LTRs.
Details
- Title: Subtitle
- GraftIQ: Hybrid multi-class neural network integrating clinical insight for multi-outcome prediction in liver transplant recipients
- Creators
- Divya Sharma - Princess Margaret Cancer CentreNeta Gotlieb - University of OttawaDaljeet Chahal - Vancouver General HospitalJoseph C Ahn - Mayo Clinic in ArizonaBastian Engel - Medizinische Hochschule HannoverRichard Taubert - Medizinische Hochschule HannoverEunice Tan - National University HospitalLau Kai Yun - Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, SingaporeSara Naimimohasses - University Health NetworkAnkit Ray - University Health NetworkYoojin Han - Ajmera Transplant Program, University Health Network, Toronto, ON, CanadaSara Gehlaut - University Health NetworkMaryam Shojaee - University Health NetworkSurabie Sivanendran - University Health NetworkMaryam Naghibzadeh - University Health NetworkAmirhossein Azhie - University Health NetworkSareh Keshavarzi - Princess Margaret Cancer CentreKai Duan - University Health NetworkLeslie Lilly - University Health NetworkNazia Selzner - University Health NetworkCynthia Tsien - University Health NetworkElmar Jaeckel - University Health NetworkWei Xu - University Health NetworkMamatha Bhat - University Health Network
- Resource Type
- Journal article
- Publication Details
- Nature communications, Vol.16(1), 4943
- DOI
- 10.1038/s41467-025-59610-8
- PMID
- 40436838
- PMCID
- PMC12120053
- NLM abbreviation
- Nat Commun
- ISSN
- 2041-1723
- eISSN
- 2041-1723
- Publisher
- Springer Nature; BERLIN
- Grant note
- American Society of Transplantation (AST)Canadian Society of Transplantation grantAmerican Society of Transplant (AST) grant: SFB738, 19_02, ZN3369 Canadian Institutes of Health Research's (CIHR) - German Research Foundation: ME 3696/3 Hannover Medical School/The Ministry of Science and Culture of the State of Lower Saxony - German Research Foundation (DFG)
We wish to thank Mary Grace Wong and Shruti Misra for helping to review the pathology reports. Supported by a Canadian Society of Transplantation grant, an American Society of Transplant (AST) grant, and Canadian Institutes of Health Research's (CIHR) grant to M.B. Grants not specifically for this unfunded study. The content is solely the responsibility of the author. This study was not funded by industry. The work was supported by grants from the German Research Foundation (SFB738 project Z2; E.J.), the Transplantation Center Project 19_02 from Hannover Medical School (R.T.), and the Transplantation Center Project ZN3369 from Hannover Medical School/The Ministry of Science and Culture of the State of Lower Saxony (B.E.). B.E. was supported by the PRACTIS-Clinician Scientist program of Hannover Medical School, funded by the German Research Foundation (DFG, ME 3696/3).
- Language
- English
- Date published
- 05/28/2025
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984825340402771
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