Determining the Level of Importance of Variables in Predicting Kidney Transplant Survival Based on a Novel Ranking Method

Transplantation. 2021 Oct 1;105(10):2307-2315. doi: 10.1097/TP.0000000000003623.

Abstract

Background: Kidney transplantation is the best alternative treatment for end-stage renal disease. To optimal use of donated kidneys, graft predicted survival can be used as a factor to allocate kidneys. The performance of prediction techniques is highly dependent on the correct selection of predictors. Hence, the main objective of this research is to propose a novel method for ranking the effective variables for predicting the kidney transplant survival.

Methods: Five classification models were used to classify kidney recipients in long- and short-term survival classes. Synthetic minority oversampling and random undersampling were used to overcome the imbalanced class problem. In dealing with missing values, 2 approaches were used (eliminating and imputing them). All variables were categorized into 4 levels. The ranking was evaluated using the sensitivity analysis approach.

Results: Thirty-four of the 41 variables were identified as important variables, of which, 5 variables were categorized in very important level ("Recipient creatinine at discharge," "Recipient dialysis time," "Donor history of diabetes," "Donor kidney biopsy," and "Donor cause of death"), 17 variables in important level, and 12 variables in the low important level.

Conclusions: In this study, we identify new variables that have not been addressed in any of the previous studies (eg, AGE_DIF and MATCH_GEN). On the other hand, in kidney allocation systems, 2 main criteria are considered: equity and utility. One of the utility subcriteria is the graft survival. Our study findings can be used in the design of systems to predict the graft survival.

Publication types

  • Comparative Study

MeSH terms

  • Decision Support Techniques*
  • Decision Trees
  • Donor Selection*
  • Graft Survival*
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / mortality
  • Neural Networks, Computer
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Support Vector Machine
  • Time Factors
  • Treatment Outcome