Ant Lion Optimization algorithm for kidney exchanges

Clinical Deployment of Machine Learning Tools in Transplant Medicine: What Does the Future Hold?

Medical applications of machine learning (ML) have shown promise in analyzing patient data to support clinical decision-making and provide patient-specific outcomes. In transplantation, several applications of ML exist which include pretransplant: patient prioritization, donor-recipient matching, organ allocation, and posttransplant outcomes. Numerous studies have shown the development and utility of ML models, which have the potential to augment transplant medicine. Despite increasing efforts to develop robust ML models for clinical use, very few of these tools are deployed in the healthcare setting. Here, we summarize the current applications of ML in transplant and discuss a potential clinical deployment framework using examples in organ transplantation. We identified that creating an interdisciplinary team, curating a reliable dataset, addressing the barriers to implementation, and understanding current clinical evaluation models could help in deploying ML models into the transplant clinic setting.

Maximizing matching, equity and survival in kidney transplantation using molecular HLA immunogenicity quantitation

HLA matching improves long-term outcomes of kidney transplantation, yet implementation challenges persist, particularly within the African American (Black) patient demographic due to donor scarcity. Consequently, kidney survival rates among Black patients significantly lag behind those of other racial groups. A refined matching scheme holds promise for improving kidney survival, with prioritized matching for Black patients potentially bolstering rates of HLA-matched transplants. To facilitate quantity, quality and equity in kidney transplants, we propose two matching algorithms based on quantification of HLA immunogenicity using the hydrophobic mismatch score (HMS) for prospective transplants. We mined the national transplant patient database (SRTR) for a diverse group of donors and recipients with known racial backgrounds. Additionally, we use novel methods to infer survival assessment in the simulated transplants generated by our matching algorithms, in the absence of actual target outcomes, utilizing modified unsupervised clustering techniques. Our allocation algorithms demonstrated the ability to match 87.7% of Black and 86.1% of White recipients under the HLA immunogenicity threshold of 10. Notably, at the lowest HMS threshold of 0, 4.4% of Black and 12.1% of White recipients were matched, a marked increase from the 1.8% and 6.6% matched under the prevailing allocation scheme. Furthermore, our allocation algorithms yielded similar or improved survival rates, as illustrated by Kaplan-Meier (KM) curves, and enhanced survival prediction accuracy, evidenced by C-indices and Integrated Brier Scores.

The promise of machine learning applications in solid organ transplantation

Solid-organ transplantation is a life-saving treatment for end-stage organ disease in highly selected patients. Alongside the tremendous progress in the last several decades, new challenges have emerged. The growing disparity between organ demand and supply requires optimal patient/donor selection and matching. Improvements in long-term graft and patient survival require data-driven diagnosis and management of post-transplant complications. The growing abundance of clinical, genetic, radiologic, and metabolic data in transplantation has led to increasing interest in applying machine-learning (ML) tools that can uncover hidden patterns in large datasets. ML algorithms have been applied in predictive modeling of waitlist mortality, donor–recipient matching, survival prediction, post-transplant complications diagnosis, and prediction, aiming to optimize immunosuppression and management. In this review, we provide insight into the various applications of ML in transplant medicine, why these were used to evaluate a specific clinical question, and the potential of ML to transform the care of transplant recipients. 36 articles were selected after a comprehensive search of the following databases: Ovid MEDLINE; Ovid MEDLINE Epub Ahead of Print and In-Process & Other Non-Indexed Citations; Ovid Embase; Cochrane Database of Systematic Reviews (Ovid); and Cochrane Central Register of Controlled Trials (Ovid). In summary, these studies showed that ML techniques hold great potential to improve the outcome of transplant recipients. Future work is required to improve the interpretability of these algorithms, ensure generalizability through larger-scale external validation, and establishment of infrastructure to permit clinical integration.

Monthly evapotranspiration estimation using optimal climatic parameters: efficacy of hybrid support vector regression integrated with whale optimization algorithm

For effective planning of irrigation scheduling, water budgeting, crop simulation, and water resources management, the accurate estimation of reference evapotranspiration (ET_o) is essential. In the current study, the hybrid support vector regression (SVR) coupled with Whale Optimization Algorithm (SVR-WOA) was employed to estimate the monthly ET_o at Algiers and Tlemcen meteorological stations positioned in the north of Algeria under three different optimal input scenarios. Monthly climatic parameters, i.e., solar radiation (R_s), wind speed (U_s), relative humidity (RH), and maximum and minimum air temperatures (T_max and T_min) of 14 years (2000-2013), were obtained from both stations. The accuracy of the hybrid SVR-WOA model was appraised against hybrid SVR-MVO (Multi-Verse Optimizer), and SVR-ALO (Ant Lion Optimizer) models through performance measures, i.e., mean absolute error (MAE), root-mean-square error (RMSE), index of scattering (IOS), index of agreement (IOA), Pearson correlation coefficient (PCC), Nash-Sutcliffe efficiency (NSE), and graphical interpretation (time-variation and scatter plots, radar chart, and Taylor diagram). The results showed that the SVR-WOA model performed superior to the SVR-MVO and SVR-ALO models at both stations in all scenarios. The SVR-WOA-1 model with five inputs (i.e., T_min, T_max, RH, U_s, R_s: scenario-1) had the lowest value of MAE = 0.0658/0.0489 mm/month, RMSE = 0.0808/0.0617 mm/month, IOS = 0.0259/0.0165, and the highest value of NSE = 0.9949/0.9989, PCC = 0.9975/0.9995, and IOA = 0.9987/0.9997 for testing period at both stations, respectively. The proposed hybrid SVR-WOA model was found to be more appropriate and efficient in comparison to SVR-MVO and SVR-ALO models for estimating monthly ET_o in the study region.