{"id":"https://openalex.org/W4416869478","doi":"https://doi.org/10.1681/asn.2025aahppxk1","title":"Predicting Delayed Graft Function Using Multimodal Artificial Intelligence (AI) with Pathomics from Deceased Donor Biopsy and Clinical Data","display_name":"Predicting Delayed Graft Function Using Multimodal Artificial Intelligence (AI) with Pathomics from Deceased Donor Biopsy and Clinical Data","publication_year":2025,"publication_date":"2025-10-01","ids":{"openalex":"https://openalex.org/W4416869478","doi":"https://doi.org/10.1681/asn.2025aahppxk1"},"language":"en","primary_location":{"id":"doi:10.1681/asn.2025aahppxk1","doi":"https://doi.org/10.1681/asn.2025aahppxk1","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025aahppxk1","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5028188091","display_name":"Jeremy Rubin","orcid":"https://orcid.org/0000-0002-8288-6022","observed_orcids":["https://orcid.org/0000-0002-8288-6022"]},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jeremy Rubin","raw_affiliation_strings":["University of Pennsylvania, Philadelphia, Pennsylvania, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Pennsylvania, Philadelphia, Pennsylvania, United States;","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111422570","display_name":"Anindya S. Paul","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Anindya S. Paul","raw_affiliation_strings":["University of Florida, Gainesville, Florida, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Florida, Gainesville, Florida, United States;","institution_ids":["https://openalex.org/I33213144"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5047205940","display_name":"Lu\u00eds Rodrigues","orcid":"https://orcid.org/0000-0003-0122-982X","observed_orcids":["https://orcid.org/0000-0003-0122-982X"]},"institutions":[{"id":"https://openalex.org/I76903346","display_name":"University of Coimbra","ror":"https://ror.org/04z8k9a98","country_code":"PT","type":"education","lineage":["https://openalex.org/I76903346"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"Luis Rodrigues","raw_affiliation_strings":["Universidade de Coimbra, Coimbra, Coimbra District, Portugal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universidade de Coimbra, Coimbra, Coimbra District, Portugal","institution_ids":["https://openalex.org/I76903346"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5116270952","display_name":"Haitham M Abdelazim","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Haitham M Abdelazim","raw_affiliation_strings":["University of Florida, Gainesville, Florida, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Florida, Gainesville, Florida, United States;","institution_ids":["https://openalex.org/I33213144"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103050353","display_name":"Akshita Gupta","orcid":"https://orcid.org/0009-0002-7440-5003","observed_orcids":["https://orcid.org/0009-0002-7440-5003"]},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Akshita Gupta","raw_affiliation_strings":["University of Florida, Gainesville, Florida, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Florida, Gainesville, Florida, United States;","institution_ids":["https://openalex.org/I33213144"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049566500","display_name":"Samuel P. Border","orcid":"https://orcid.org/0000-0002-8806-6965","observed_orcids":["https://orcid.org/0000-0002-8806-6965"]},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Samuel Border","raw_affiliation_strings":["University of Florida, Gainesville, Florida, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Florida, Gainesville, Florida, United States;","institution_ids":["https://openalex.org/I33213144"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5008273770","display_name":"Clara Pardinhas","orcid":"https://orcid.org/0000-0001-9075-5797","observed_orcids":["https://orcid.org/0000-0001-9075-5797"]},"institutions":[{"id":"https://openalex.org/I76903346","display_name":"University of Coimbra","ror":"https://ror.org/04z8k9a98","country_code":"PT","type":"education","lineage":["https://openalex.org/I76903346"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"Clara Pardinhas","raw_affiliation_strings":["Universidade de Coimbra, Coimbra, Coimbra District, Portugal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universidade de Coimbra, Coimbra, Coimbra District, Portugal","institution_ids":["https://openalex.org/I76903346"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5059517740","display_name":"Vitor Manuel Leit\u00e3o de Sousa","orcid":"https://orcid.org/0000-0003-3219-1078","observed_orcids":["https://orcid.org/0000-0003-3219-1078"]},"institutions":[{"id":"https://openalex.org/I76903346","display_name":"University of Coimbra","ror":"https://ror.org/04z8k9a98","country_code":"PT","type":"education","lineage":["https://openalex.org/I76903346"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"Vitor Manuel Leit\u00e3o de Sousa","raw_affiliation_strings":["Universidade de Coimbra, Coimbra, Coimbra District, Portugal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universidade de Coimbra, Coimbra, Coimbra District, Portugal","institution_ids":["https://openalex.org/I76903346"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027413213","display_name":"Arnaldo Figueiredo","orcid":"https://orcid.org/0000-0002-7157-0081","observed_orcids":["https://orcid.org/0000-0002-7157-0081"]},"institutions":[{"id":"https://openalex.org/I76903346","display_name":"University of Coimbra","ror":"https://ror.org/04z8k9a98","country_code":"PT","type":"education","lineage":["https://openalex.org/I76903346"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"Arnaldo Figueiredo","raw_affiliation_strings":["Universidade de Coimbra, Coimbra, Coimbra District, Portugal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universidade de Coimbra, Coimbra, Coimbra District, Portugal","institution_ids":["https://openalex.org/I76903346"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5039697869","display_name":"Jarcy Zee","orcid":"https://orcid.org/0000-0003-0586-1160","observed_orcids":["https://orcid.org/0000-0003-0586-1160"]},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jarcy Zee","raw_affiliation_strings":["University of Pennsylvania, Philadelphia, Pennsylvania, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Pennsylvania, Philadelphia, Pennsylvania, United States;","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5044061952","display_name":"Pinaki Sarder","orcid":"https://orcid.org/0000-0003-2450-5233","observed_orcids":["https://orcid.org/0000-0003-2450-5233"]},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Pinaki Sarder","raw_affiliation_strings":["University of Florida, Gainesville, Florida, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Florida, Gainesville, Florida, United States;","institution_ids":["https://openalex.org/I33213144"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.56320573,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"36","issue":"10S","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10373","display_name":"Renal Transplantation Outcomes and Treatments","score":0.8496000170707703,"subfield":{"id":"https://openalex.org/subfields/2747","display_name":"Transplantation"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10373","display_name":"Renal Transplantation Outcomes and Treatments","score":0.8496000170707703,"subfield":{"id":"https://openalex.org/subfields/2747","display_name":"Transplantation"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11163","display_name":"Organ Donation and Transplantation","score":0.07859999686479568,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12422","display_name":"Radiomics and Machine Learning in Medical Imaging","score":0.018200000748038292,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/delayed-graft-function","display_name":"delayed graft function","score":1.0},{"id":"https://openalex.org/keywords/kidney-transplantation","display_name":"kidney transplantation","score":0.9559999704360962},{"id":"https://openalex.org/keywords/pathomics","display_name":"pathomics","score":0.9399999976158142},{"id":"https://openalex.org/keywords/kidney-donor-profile-index","display_name":"Kidney Donor Profile Index","score":0.8650000095367432},{"id":"https://openalex.org/keywords/vascular-injury","display_name":"vascular injury","score":0.3720000088214874},{"id":"https://openalex.org/keywords/glomerulosclerosis","display_name":"glomerulosclerosis","score":0.9800000190734863},{"id":"https://openalex.org/keywords/ischemic-injury","display_name":"ischemic injury","score":0.4880000054836273},{"id":"https://openalex.org/keywords/risk-prediction-model","display_name":"risk prediction model","score":0.5580000281333923},{"id":"https://openalex.org/keywords/multimodal-data-integration","display_name":"multimodal data integration","score":0.5170000195503235}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.815500020980835},{"id":"https://openalex.org/C2775934546","wikidata":"https://www.wikidata.org/wiki/Q179991","display_name":"Biopsy","level":2,"score":0.5249000191688538},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.41690000891685486},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.38909998536109924},{"id":"https://openalex.org/C3018822202","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Patient data","level":2,"score":0.3278999924659729},{"id":"https://openalex.org/C2780303639","wikidata":"https://www.wikidata.org/wiki/Q740909","display_name":"Kidney transplantation","level":3,"score":0.3127000033855438},{"id":"https://openalex.org/C14036430","wikidata":"https://www.wikidata.org/wiki/Q3736076","display_name":"Function (biology)","level":2,"score":0.2919999957084656},{"id":"https://openalex.org/C2911091166","wikidata":"https://www.wikidata.org/wiki/Q106419912","display_name":"Transplantation","level":2,"score":0.28360000252723694},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2799000144004822},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.2757999897003174},{"id":"https://openalex.org/C3019230761","wikidata":"https://www.wikidata.org/wiki/Q1765748","display_name":"Graft rejection","level":3,"score":0.2533000111579895}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1681/asn.2025aahppxk1","doi":"https://doi.org/10.1681/asn.2025aahppxk1","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025aahppxk1","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9922999739646912}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7204102810","https://openalex.org/W4405236083","https://openalex.org/W4416869307","https://openalex.org/W4394942608","https://openalex.org/W3212789596","https://openalex.org/W7104505467","https://openalex.org/W3018325149","https://openalex.org/W7204840604","https://openalex.org/W7154857223","https://openalex.org/W7165366830"],"abstract_inverted_index":{"Background:":[0],"Delayed":[1],"graft":[2],"function":[3],"(DGF)":[4],"is":[5,14],"an":[6,219],"early":[7,56,263],"indicator":[8],"of":[9,97,131,204,221],"kidney":[10,71,267],"transplant":[11,72],"injury":[12,22,229],"and":[13,23,69,83,116,140,145,154,168,179,240,248],"associated":[15],"with":[16,47,74,93,126,197],"worse":[17],"long-term":[18],"outcomes.":[19],"While":[20],"ischemic":[21],"other":[24],"donor-related":[25],"pathology":[26],"contribute,":[27],"existing":[28],"clinical":[29,45,242,247],"tools":[30],"lack":[31],"precision":[32],"in":[33,77,266],"predicting":[34],"DGF.":[35],"We":[36,61,148],"aimed":[37],"to":[38,54,171],"develop":[39],"a":[40,94,202,215],"predictive":[41],"model":[42],"combining":[43],"donor":[44,241,246],"data":[46,250],"pathomic":[48,133,249],"features":[49,134,160],"extracted":[50],"from":[51,65,102],"procurement":[52,63],"biopsies":[53,64],"improve":[55],"DGF":[57,75,252],"risk":[58,264],"stratification.":[59],"Methods:":[60],"analyzed":[62],"110":[66],"deceased":[67],"donors":[68],"139":[70],"recipients,":[73],"occurring":[76],"16.5%.":[78],"Biopsies":[79],"were":[80,88,124,135,182],"FFPE-processed,":[81],"PAS-stained,":[82],"digitized":[84],"at":[85],"40x.":[86],"Donors":[87],"64.5%":[89],"male,":[90],"100%":[91],"white,":[92],"mean":[95],"age":[96],"62.3":[98],"years;":[99],"68.2%":[100],"died":[101],"stroke.":[103],"KDPI":[104,209,256],"averaged":[105],"69.5":[106],"(39.5%":[107],">85%).":[108],"Using":[109],"ComPRePS":[110],"[https://compreps.wiki/home],":[111],"glomeruli,":[112],"tubules,":[113],"arteries,":[114],"arterioles,":[115],"key":[117],"lesions":[118],"(e.g.,":[119,231],"IFTA,":[120],"vascular":[121,228],"fibrointimal":[122],"sclerosis)":[123],"segmented":[125],"expert":[127],"validation.":[128],"A":[129],"total":[130],"306":[132],"extracted,":[136],"quantifying":[137],"structure,":[138],"size,":[139],"texture":[141],"across":[142],"eosinophilic,":[143],"luminal,":[144],"nuclear":[146],"subregions.":[147],"trained":[149],"LASSO,":[150],"ridge,":[151],"elastic":[152],"net,":[153],"random":[155],"forest":[156],"(RF)":[157],"models":[158],"using":[159,187],"selected":[161],"via":[162],"Minimum":[163],"Redundancy":[164],"Maximum":[165],"Relevance":[166],"(MRMR),":[167],"compared":[169],"them":[170],"Kidney":[172],"Donor":[173],"Profile":[174],"Index":[175],"(KDPI)":[176],"alone.":[177,257],"Bootstrapping":[178],"five-fold":[180],"cross-validation":[181],"used.":[183],"Performance":[184],"was":[185],"evaluated":[186],"the":[188],"concordance":[189],"statistic":[190],"(C-statistic).":[191],"Results:":[192],"The":[193],"top-performing":[194],"model,":[195],"RF":[196],"26":[198],"MRMR-selected":[199],"features,":[200],"reached":[201],"C-statistic":[203],"0.94":[205],"versus":[206],"0.5":[207],"for":[208],"(left":[210],"figure).":[211,224],"ROC":[212],"analysis":[213],"on":[214],"hold-out":[216],"set":[217],"yielded":[218],"AUC":[220],"0.81":[222],"(right":[223],"Key":[225],"predictors":[226],"included":[227],"markers":[230],"nuclear-to-object":[232],"ratio,":[233],"arteriolar":[234],"distance":[235],"transform,":[236],"luminal":[237],"homogeneity),":[238],"glomerulosclerosis,":[239],"factors.":[243],"Conclusion:":[244],"Combining":[245],"enhances":[251],"prediction":[253],"accuracy,":[254],"outperforming":[255],"This":[258],"approach":[259],"may":[260],"support":[261],"better":[262],"stratification":[265],"transplantation.":[268],"Funding:":[269],"NIDDK":[270],"Support":[271]},"counts_by_year":[],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2025-12-01T00:00:00"}