Artificial Intelligence: Present and Future Potential for Solid Organ Transplantation
Open accessAbstract
Artificial intelligence (AI) refers to computer algorithms used to complete tasks that usually require human intelligence. Typical examples include complex decision-making and- image or speech analysis. AI application in healthcare is rapidly evolving and it undoubtedly holds an enormous potential for the field of solid organ transplantation. In this review, we provide an overview of AI-based approaches in solid organ transplantation. Particularly, we identified four key areas of transplantation which could be facilitated by AI: organ allocation and donor-recipient pairing, transplant oncology, real-time immunosuppression regimes, and precision transplant pathology. The potential implementations are vast—from improved allocation algorithms, smart donor-recipient matching and dynamic adaptation of immunosuppression to automated analysis of transplant pathology. We are convinced that we are at the beginning of a new digital era in transplantation, and that AI has the potential to improve graft and patient survival. This manuscript provides a glimpse into how AI innovations could shape an exciting future for the transplantation community.
AI snapshot
Written from the paper’s full text.
TL;DR
This narrative review surveys AI applications in solid organ transplantation across organ allocation/donor-recipient matching, transplant oncology, immunosuppression, and transplant pathology. It argues AI has potential to improve graft and patient survival but remains mostly under development, with many algorithms still needing external validation.
Key findings
- AI-based allocation and matching models showed improved predictions over standard scores: OPOM used 1,618,966 observations and reduced mortality on average by 417.96 deaths for 6,139 liver transplantations; MADR-E AI-ANNs predicted graft survival (AUC 0.81) and graft loss (AUC 0.82); Bae et al.’s random survival forest achieved a C-statistic of 0.637 versus 0.6 for KDRI.
- In transplant oncology, AI models outperformed traditional criteria: MORAL pre- and post-transplant scores had C-statistics of 0.82 and 0.86 versus 0.63 for Milan criteria, and 0.91 when combined; Metroticket 2.0 showed external validation accuracy of 0.721 (95% CI 0.648–0.793) for 5-year survival; a Toronto CoxNet calculator outperformed AFP by 0.118, MORAL by 0.130, and HALT-HCC by 0.102.
- For immunosuppression, machine learning predicted tacrolimus stable dose better than logistic regression, though with a relatively small difference; a three-gene urinary signature predicted acute kidney rejection with AUC 0.85 internally and 0.74 externally.
- In transplant pathology, deep learning classified kidney biopsy components across centers but struggled with sclerotic glomeruli and atrophic tubuli; machine learning also quantified liver steatosis in frozen sections and was highly accurate compared with an expert pathologist.
Methods
- Narrative review identifying four key areas: organ allocation and donor-recipient pairing, transplant oncology, real-time immunosuppression regimes, and precision transplant pathology.
- No primary data collection; the paper synthesizes published AI, machine learning, and deep learning studies, including registry datasets and clinical cohorts cited in the text.
- Main analysis is a qualitative discussion of cited model performance metrics and potential clinical implementations; no systematic search strategy or meta-analysis is described.
Limitations
- Stated in the paper: several algorithms were developed in a single institution and still need external validation; in some cases AI cannot provide significant improvements over current models; the best strategy for implementing AI into daily clinical practice is unclear; many physicians remain unconvinced AI can play a weighty role in medicine.
- Stated for cited work: Yasodhara et al. had a retrospective design, missing comorbidity data, unclear immunosuppression information, and unusually few patients with steatohepatitis; OPOM and the Toronto HCC-recurrence calculator still require external validation.
- Evident from the text: as a narrative review, it lacks a systematic search strategy, inclusion criteria, risk-of-bias assessment, and quantitative pooling, so conclusions rely on selected examples rather than a comprehensive evidence synthesis.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 66 cited sources checked · 0 supported · 0 flagged
- Premisecitation
The allocation process depends on the timeframe during which the organ remains viable once harvested, which ranges from a few to 36 h, depending on the organ.
“Additionally, the allocation (and donor-recipient matching) process depends on the timeframe during which the organ remains viable once harvested, which ranges from a few to 36 h, depending on the organ (5).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] Messner, 2019, Emerging Technologies in Organ Preservation, Tissue Engineering and Regenerative Medicine: A Blessing or Curse for Transplantation?, Transpl Int source
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- Premisecitation
OPOM predicts the probability of a patient's 3-month mortality or waitlist removal given their characteristics.
“This model, named Optimal Prediction of Mortality (OPOM), predicts the probability of a patient’s 3-month mortality or waitlist removal given their characteristics.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] Bertsimas, 2019, Development and Validation of an Optimized Prediction of Mortality for Candidates Awaiting Liver Transplantation, Am J Transpl source
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- Premisecitation
Using the Standard Transplant Analysis and Research dataset, OPOM provided more accurate and objective predictions than MELD.
“Using the Standard Transplant Analysis and Research dataset (1618966 observations), OPOM provided more accurate and objective predictions than MELD.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] Bertsimas, 2019, Development and Validation of an Optimized Prediction of Mortality for Candidates Awaiting Liver Transplantation, Am J Transpl source
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- Premisecitation
Bertsimas and co-workers proposed a machine learning-based model for alternative liver allocation, named OPOM.
“In 2019, Bertsimas and co-workers proposed a machine learning-based model for alternative liver allocation (8).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] Bertsimas, 2019, Development and Validation of an Optimized Prediction of Mortality for Candidates Awaiting Liver Transplantation, Am J Transpl source
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- Premisecitation
The Child-Pugh classification, MELD, KAS and LAS are the most important algorithms currently used.
“The Child-Pugh classification, the Model of End Stage Liver Disease (MELD), the Kidney Allocation System (KAS) and the Lung Allocation System (LAS) are the most important algorithms currently used (6).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] UNOS Allocation Calculators (2022)
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- Premisecitation
The OPOM simulation reduced mortality on average by 417.96 deaths for 6139 liver transplantations by assigning different priority to liver transplant candidates.
“Additionally, the OPOM simulation reduced mortality on average by 417.96 deaths for 6139 liver transplantations by assigning different priority to liver transplant candidates.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] Bertsimas, 2019, Development and Validation of an Optimized Prediction of Mortality for Candidates Awaiting Liver Transplantation, Am J Transpl source
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- Premisecitation
Cruz-Ramirez et al. reported the use of AI artificial neural networks to improve donor-recipient pairing.
“In 2013, Cruz-Ramirez et al. reported the use of AI artificial neural networks (AI-ANNs) to improve donor-recipient pairing.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [11] Cruz-Ramírez, 2013, Predicting Patient Survival after Liver Transplantation Using Evolutionary Multi-Objective Artificial Neural Networks, Artif Intell Med source
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- Premisecitation
Rana and coworkers developed the SOFT score that integrates recipient and donor characteristics to predict liver transplant 3-month prognosis.
“Similarly, Rana and coworkers used the Organ Procurement and Transplantation Network (OPTN)/Scientific Registry of Transplant Recipients (SRTR) data to develop the Survival Outcome Following Liver Transplant (SOFT) score that integrates recipient and donor characteristics to predict liver transplant 3-month prognosis (13).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [13] Rana, 2008, Survival Outcomes Following Liver Transplantation (SOFT) Score: A Novel Method to Predict Patient Survival Following Liver Transplantation, Am J Transpl source
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- Study design and conductcitation
The Yasodhara model was externally validated on a cohort of patients (University Health Network dataset from Toronto, Canada).
“Additionally, the model was externally validated on a cohort of patients (University Health Network dataset from Toronto, Canada).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Yasodhara, 2021, Identifying Modifiable Predictors of Long‐Term Survival in Liver Transplant Recipients with Diabetes Mellitus Using Machine Learning, Liver Transpl source
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- Premisecitation
AI-ANNs' new algorithms predicted graft survival (AUC 0.81) and graft loss (AUC 0.82) better than the isolated donor/recipient scores.
“AI-ANNs’ new algorithms predicted graft survival (AUC, 0.81) and graft loss (AUC, 0.82) better than the isolated donor/recipient scores.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [12] Briceño, 2014, Use of Artificial Intelligence as an Innovative Donor-Recipient Matching Model for Liver Transplantation: Results from a Multicenter Spanish Study, J Hepatol source
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- Premisecitation
Yasodhara et al. demonstrated the value of AI for successful liver donor-recipient matching by including the metabolic status of the recipient.
“Recently, Yasodhara et al. demonstrated the value of AI for successful liver donor-recipient matching, by including the metabolic status of the recipient (16).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Yasodhara, 2021, Identifying Modifiable Predictors of Long‐Term Survival in Liver Transplant Recipients with Diabetes Mellitus Using Machine Learning, Liver Transpl source
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- Premisecitation
The Yasodhara model performance achieved C-statistics between 0.58 and 0.66.
“The model performance achieved C-statistics between 0.58 and 0.66.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Yasodhara, 2021, Identifying Modifiable Predictors of Long‐Term Survival in Liver Transplant Recipients with Diabetes Mellitus Using Machine Learning, Liver Transpl source
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- Premisecitation
The SOFT score demonstrated a predictive accuracy similar to those of other models with a C-statistic of 0.70.
“The SOFT score demonstrated a predictive accuracy similar to those of other models (14, 15) with a C-statistic of 0.70.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [14] Ioannou, 2006, Development and Validation of a Model Predicting Graft Survival after Liver Transplantation, Liver Transpl source
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- cites [15] JacobLewsey, 2005, Systematic Review and Validation of Prognostic Models in Liver Transplantation, Liver Transpl source
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- Premisecitation
Diabetes is a superior predictor of outcome than obesity in liver transplant patients with diabetes.
“AI and machine learning enabled the authors to analyze the huge and heterogeneous dataset and conclude that diabetes is a superior predictor of outcome than obesity, which resulted in changes in practice in donor-recipient matching.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Yasodhara, 2021, Identifying Modifiable Predictors of Long‐Term Survival in Liver Transplant Recipients with Diabetes Mellitus Using Machine Learning, Liver Transpl source
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- Premisecitation
The Metroticket 2.0 score predicts survival after liver transplantation for HCC through competing-risk analysis.
“The Metroticket 2.0 score proposed by Mazzaferro and coworkers (22) predicts survival after liver transplantation for HCC through competing-risk analysis.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [22] Mazzaferro, 2018, Metroticket 2.0 Model for Analysis of Competing Risks of Death after Liver Transplantation for Hepatocellular Carcinoma, Gastroenterology source
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- Premisecitation
The Metroticket 2.0 validation set showed an accuracy of 0.721 (95% CI, 0.648%-0.793%) in predicting 5-year survival after liver transplant.
“The validation set showed an accuracy of 0.721 (95% CI, 0.648%–0.793%) in predicting 5-year survival after liver transplant.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [22] Mazzaferro, 2018, Metroticket 2.0 Model for Analysis of Competing Risks of Death after Liver Transplantation for Hepatocellular Carcinoma, Gastroenterology source
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- Premisecitation
Bae et al. proposed an online tool to maximize benefits from marginal kidney donors.
“In 2019, Bae et al. proposed an online tool (https://www.transplantmodels.com/kdpi-epts/) (17) to maximize benefits form marginal kidney donors.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Bae, 2019, Who Can Tolerate a Marginal Kidney? Predicting Survival after Deceased Donor Kidney Transplant by Donor-Recipient Combination, Am J Transpl source
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- Premisecitation
When combined, the two MORAL scores achieved a C-statistic of 0.91.
“When combined, the two scores achieved a C-statistic of 0.91.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [21] Halazun, 2017, Recurrence after Liver Transplantation for Hepatocellular Carcinoma: A New MORAL to the story, Ann Surg source
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- Premisecitation
Halazun et al. developed the MORAL model which identified predicting factors of tumor recurrence pre- and post-liver transplantation.
“Halazun KJ et al. developed a model (MORAL - Model of Recurrence after Liver Transplant) which identified predicting factors of tumor recurrence pre- and post- liver transplantation (21).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [21] Halazun, 2017, Recurrence after Liver Transplantation for Hepatocellular Carcinoma: A New MORAL to the story, Ann Surg source
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- Premisecitation
Nitski et al. analyzed large retrospective datasets with machine learning algorithms to predict mortality in liver transplant patients.
“Taking a more general approach, Nitski et al. analyzed large retrospective datasets with machine learning algorithms to predict mortality in liver transplant patients (34).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Nitski, 2021, Long-term Mortality Risk Stratification of Liver Transplant Recipients: Real-Time Application of Deep Learning Algorithms on Longitudinal Data, Lancet Digital Health source
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- Premisecitation
The Sapisochin group described the use of AI for predicting post-transplant recurrence of HCC based on preoperative patient and tumor characteristics.
“Recently, the group lead by Prof. Sapisochin described the use of AI for predicting the post-transplant recurrence of HCC based on preoperative patient and tumor characteristics (23).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [23] Ivanics, 2021, The Toronto Post Liver Transplant Hepatocellular Carcinoma Recurrence Calculator: A Machine Learning Approach, Liver Transpl source
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- Premisecitation
All three studies comparing logistic regression to machine learning algorithms for predicting stable tacrolimus dose in kidney transplant patients showed a superior predictive ability of machine learning tools over linear regression models, albeit with a relatively small difference.
“All studies showed a superior predictive ability of machine learning tools over the linear regression models, albeit with a relatively small difference.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [31] Min, 2021, An Integrated Clinical and Genetic Prediction Model for Tacrolimus Levels in Pediatric Solid Organ Transplant Recipients, Transplantation source
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- cites [32] Thishya, 2018, Artificial Neural Network Model for Predicting the Bioavailability of Tacrolimus in Patients with Renal Transplantation, PLoS One source
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- cites [33] Tang, 2017, Application of Machine-Learning Models to Predict Tacrolimus Stable Dose in Renal Transplant Recipients, Sci Rep source
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- Premisecitation
Using combination of genomic data and clinical factors was shown more important than the choice of algorithm.
“Using combination of genomic data and clinical factors was shown more important than the choice of algorithm.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [31] Min, 2021, An Integrated Clinical and Genetic Prediction Model for Tacrolimus Levels in Pediatric Solid Organ Transplant Recipients, Transplantation source
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- Interpretationcitation
An AI-based calculator can generate a comprehensive prediction of post-transplant HCC recurrence with higher accuracy than alternative scores, pending an external validation.
“These findings confirm, pending an external validation, that an AI-based calculator can generate a comprehensive prediction of post-transplant HCC recurrence with higher accuracy than alternative scores.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [23] Ivanics, 2021, The Toronto Post Liver Transplant Hepatocellular Carcinoma Recurrence Calculator: A Machine Learning Approach, Liver Transpl source
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- Premisecitation
Metroticket 2.0 demonstrated a superior predictive ability compared to Milan, Up-to-7 and UCSF criteria.
“This model was compared to Milan, Up-to-7 and UCSF criteria, demonstrating a superior predictive ability.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [22] Mazzaferro, 2018, Metroticket 2.0 Model for Analysis of Competing Risks of Death after Liver Transplantation for Hepatocellular Carcinoma, Gastroenterology source
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- Premisecitation
The Nitski model provided meaningful predictions based on readily available data such as graft age, blood values, donor age, and postoperative complications.
“Interestingly, the model provided meaningful predictions based on readily available data such as graft age, blood values, donor age, and postoperative complications, making a potential clinical implementation relatively straightforward.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Nitski, 2021, Long-term Mortality Risk Stratification of Liver Transplant Recipients: Real-Time Application of Deep Learning Algorithms on Longitudinal Data, Lancet Digital Health source
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- Premisecitation
Furness et al. developed a machine learning algorithm that diagnosed acute kidney allograft rejection more accurately than expert pathologists.
“More than 2 decades ago, Furness et al. developed a machine learning algorithm that diagnosed the acute kidney allograft rejection more accurately than expert pathologists (43).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [43] Furness, 1999, A Neural Network Approach to the Biopsy Diagnosis of Early Acute Renal Transplant Rejection, Histopathology source
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- Premisecitation
Commercial digital pathology slide scanners for high-throughput imaging have only recently become available.
“Commercial digital pathology slide scanners for high-throughput imaging have only recently become available (44, 45).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [44] Bera, 2019, Artificial Intelligence in Digital Pathology - New Tools for Diagnosis and Precision Oncology, Nat Rev Clin Oncol source
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- cites [45] Farris, 2020, Banff Digital Pathology Working Group: Going Digital in Transplant Pathology, Am J Transpl source
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- Interpretationreasoning
AI can integrate high-complexity information from many sources into the decision-making tree used in individualized immunosuppression.
“AI can integrate high-complexity information from many sources into the decision-making tree used in individualized immunosuppression.”
Quote in the paperSubstantial claim - Premisecitation
The Furness et al. algorithm was not fully automated-it relied on manual extraction of pathological features from histological slides.
“However, the algorithm was not fully automated—it relied on manual extraction of pathological features from histological slides.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [43] Furness, 1999, A Neural Network Approach to the Biopsy Diagnosis of Early Acute Renal Transplant Rejection, Histopathology source
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- Premisecitation
Suthanthiran et al. used the transcriptomes of urinary cells from 220 patients to predict acute rejection based on kidney biopsies.
“Suthanthiran et al. used the transcriptomes of urinary cells from 220 patients to predict acute rejection based on kidney biopsies (36).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [36] Suthanthiran, 2013, Urinary-cell mRNA Profile and Acute Cellular Rejection in Kidney Allografts, N Engl J Med source
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- Premisecitation
Several groups have developed deep learning algorithms to assess the degree of steatosis in liver biopsies.
“Recently, several groups have developed deep learning algorithms to assess the degree of steatosis in liver biopsies (47–49).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [47] Roy, 2020, Deep-learning-based Accurate Hepatic Steatosis Quantification for Histological Assessment of Liver Biopsies, Lab Invest source
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- cites [48] Forlano, 2020, High-Throughput, Machine Learning-Based Quantification of Steatosis, Inflammation, Ballooning, and Fibrosis in Biopsies from Patients with Nonalcoholic Fatty Liver Disease, Clin Gastroenterol Hepatol source
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- cites [49] Cesaretti, 2020, Use of Artificial Intelligence as an Innovative Method for Liver Graft Macrosteatosis Assessment, Liver Transpl source
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- Premisecitation
Perez-Sanz et al. developed a quick and easy workflow to quantify steatosis content in Sudan-stained frozen sections of procurement biopsies through machine learning.
“Perez-Sanz et al. developed a quick and easy workflow to quantify steatosis content in Sudan-stained frozen sections of procurement biopsies through machine learning.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Pérez-Sanz, 2021, Efficiency of Machine Learning Algorithms for the Determination of Macrovesicular Steatosis in Frozen Sections Stained with Sudan to Evaluate the Quality of the Graft in Liver Transplantation, Sensors (Basel) source
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- Premisecitation
In some cases, the use of AI cannot provide significant improvements over current models.
“Secondly, in some cases, the use of AI cannot provide significant improvements over current models (58–60).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [58] Balch, 2021, Machine Learning Applications in Solid Organ Transplantation and Related Complications, Front Immunol source
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- cites [59] Kantidakis, 2020, Survival Prediction Models since Liver Transplantation - Comparisons between Cox Models and Machine Learning Techniques, BMC Med Res Methodol source
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- cites [60] Miller, 2019, Predictive Abilities of Machine Learning Techniques May Be Limited by Dataset Characteristics: Insights from the UNOS Database, J Card Fail source
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- Premisecitation
Several AI algorithms have been developed in a single institution and still need external validation to prove their robustness.
“Several algorithms have been developed in a single institution and still need an external validation to prove their robustness.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [58] Balch, 2021, Machine Learning Applications in Solid Organ Transplantation and Related Complications, Front Immunol source
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- Classified as probably not a substantial claim. 12
- May combine two claims. 22
Probably not a substantial claim: may not pass S2 (checkable), S4 (based).
Interpretationnone givenAI has the potential to improve graft and patient survival in solid organ transplantation.
“We are convinced that we are at the beginning of a new digital era in transplantation, and that AI has the potential to improve graft and patient survival.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe allocation systems used by Eurotransplant and UNOS are intended as objective and transparent procedures to make the best possible match.
“The allocation systems used by Eurotransplant in Europe, and the United Network for Organ Sharing (UNOS) in the US, are intended as objective and transparent procedures to make the best possible match (3, 4).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [3] UNOS Organ Procurement and Allocation Policies (2022)
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- cites [4] Eurotransplant Allocation System (2022)
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PremisecitationCurrent allocation systems cannot prioritize recipients in real time and need constant modifications and addition of exceptions.
“Whilst well integrated into clinical practice, these systems cannot prioritize recipients in real time and need constant modifications (7) and addition of exceptions.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] Briceño, 2020, Artificial Intelligence and Organ Transplantation: Challenges and Expectations, Curr Opin Organ Transpl source
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Classified as probably not a substantial claim. May combine two claims.
Interpretationnone givenFour key areas of transplantation could be facilitated by AI: organ allocation and donor-recipient pairing, transplant oncology, real-time immunosuppression regimes, and precision transplant pathology.
“Particularly, we identified four key areas of transplantation which could be facilitated by AI: organ allocation and donor-recipient pairing, transplant oncology, real-time immunosuppression regimes, and precision transplant pathology.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenExternal validation of OPOM still needs to be performed.
“External validation still needs to be performed.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationBriceño et al. designed a 3-month graft mortality prediction model and performed binary analysis for donor-recipient matching via AI-ANNs.
“In their work, Briceño et al. designed a 3-month graft mortality prediction model based on 64 donor and recipient characteristics and performed a binary analysis (graft survival/loss) for donor-recipient matching via AI-ANNs.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [12] Briceño, 2014, Use of Artificial Intelligence as an Innovative Donor-Recipient Matching Model for Liver Transplantation: Results from a Multicenter Spanish Study, J Hepatol source
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PremisecitationNeutrophil-lymphocyte ratio ≤5, AFP > 200 ng/ml and tumor size >3 cm are pre-transplantation predictive factors of decreased recurrence-free survival.
“Specifically, neutrophil-lymphocyte ratio ≤5, alpha-fetoprotein (AFP) > 200 ng/ml and tumor size >3 cm have been classified as pre-transplantation predictive factors of decreased recurrence-free survival.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [21] Halazun, 2017, Recurrence after Liver Transplantation for Hepatocellular Carcinoma: A New MORAL to the story, Ann Surg source
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PremisecitationThe Bae et al. evaluation yielded a C-statistic of 0.637 for the RSF algorithm, which is slightly higher than the KDRI model's 0.6.
“The result of the evaluation yielded a C-statistic of 0.637 for the RSF algorithm, which is slightly higher than the Kidney Donor Risk Index (KDRI) model’s 0.6.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Bae, 2019, Who Can Tolerate a Marginal Kidney? Predicting Survival after Deceased Donor Kidney Transplant by Donor-Recipient Combination, Am J Transpl source
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PremisecitationBoth MORAL scores demonstrated predictive superiority (C-statistic of 0.82 and 0.86, respectively) compared to Milan criteria (C-statistic of 0.63) for forecasting tumor recurrence.
“Both scored (pre- and post-transplant) demonstrated predictive superiority (C-statistic of 0.82 and 0.86, respectively) when compared to Milan criteria for forecasting tumor recurrence (C-statistic of 0.63).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [21] Halazun, 2017, Recurrence after Liver Transplantation for Hepatocellular Carcinoma: A New MORAL to the story, Ann Surg source
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PremisecitationHCC grade 4, tumor size >3 cm, >3 tumor lesions, and vascular invasion are post-transplantation negative predictive factors.
“Likewise, HCC grade 4, tumor size >3 cm, > 3 tumor lesions, and vascular invasion have been identified as post-transplantation negative predictive factors.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [21] Halazun, 2017, Recurrence after Liver Transplantation for Hepatocellular Carcinoma: A New MORAL to the story, Ann Surg source
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PremisecitationThe CoxNet-based algorithm outperformed AFP by 0.118, MORAL by 0.130 and HALT-HCC by 0.102.
“The CoxNet-based algorithm outperformed AFP by 0.118, MORAL by 0.130 and HALT-HCC by 0.102.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [23] Ivanics, 2021, The Toronto Post Liver Transplant Hepatocellular Carcinoma Recurrence Calculator: A Machine Learning Approach, Liver Transpl source
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PremisecitationHermsen et al. developed and successfully implemented a deep learning algorithm (a convolutional neural network) that divided kidney biopsies from different centers into their anatomical components.
“In a recent study, Hermsen et al., successfully implemented a deep learning algorithm to divide kidney biopsies from different centers into their anatomical components (46).”
- Also stated in: § AI in Transplant Pathology · plain
“The authors developed a convolutional neural network that classified each anatomical component.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [46] Hermsen, 2019, Deep Learning-Based Histopathologic Assessment of Kidney Tissue, J Am Soc Nephrol source
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- Also stated in: § AI in Transplant Pathology · plain
May combine two claims.
InterpretationreasoningAI can help tap into the potential of underutilized donor and recipient information to fine-tune immunosuppression, and optimize graft and patient survival.
“AI can help us tap into this potential to fine-tune immunosuppression, and optimize graft and patient survival.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationA three-gene expression signature obtained an AUC of 0.85 for the discrimination between acute rejection and no rejection in the authors' own cohort, and an AUC of 0.74 upon external validation.
“The authors obtained an AUC of 0.85 with a three-gene expression signature for the discrimination between acute rejection and no rejection in their own cohort, and an AUC of 0.74 upon external validation.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [36] Suthanthiran, 2013, Urinary-cell mRNA Profile and Acute Cellular Rejection in Kidney Allografts, N Engl J Med source
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PremisecitationThe Hermsen et al. algorithm performed well in identifying healthy glomeruli but struggled to identify more challenging structures such as sclerotic glomeruli or atrophic tubuli.
“While the algorithm performed well in identifying healthy glomeruli, it struggled to identify more challenging structures such as sclerotic glomeruli or atrophic tubuli.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [46] Hermsen, 2019, Deep Learning-Based Histopathologic Assessment of Kidney Tissue, J Am Soc Nephrol source
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PremisecitationThe Perez-Sanz et al. algorithm, available as an open-source interactive web platform, proved highly accurate in comparison with the assessment of an expert pathologist.
“Their algorithm, available as an open-source interactive web platform (50), proved highly accurate in comparison with the assessment of an expert pathologist.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Pérez-Sanz, 2021, Efficiency of Machine Learning Algorithms for the Determination of Macrovesicular Steatosis in Frozen Sections Stained with Sudan to Evaluate the Quality of the Graft in Liver Transplantation, Sensors (Basel) source
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Probably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningThe Hermsen et al. study provides important groundwork and paves the way for further image analysis of kidney transplant biopsies.
“Nevertheless, this study provides important groundwork and paves the way for further image analysis of kidney transplant biopsies.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
InterpretationreasoningThis steatosis-quantification tool could be extremely valuable for decision-making in remote procurement locations, where an expert pathologist is not readily available.
“This tool could be extremely valuable for the decision-making in remote procurement locations, where an expert pathologist is not readily available.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationcitationThe challenges ahead for bringing AI to transplant pathology are implementing digital workflows to routinely scan histological slides and collaborating between centers to establish image databases and bring existing AI tools to transplant pathology.
“Challenges that lie ahead are the implementation of digital workflows to routinely scan histological slides, and collaboration between centers to establish image databases and bring the existing AI tools to transplant pathology (57).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [57] Loupy, 2020, The Banff 2019 Kidney Meeting Report (I): Updates on and Clarification of Criteria for T Cell- and Antibody‐mediated Rejection, Am J Transpl source
Not checked in the free run.
May combine two claims.
PremisecitationRadiology is one step ahead and shows what is possible with the emerging field of radiomics-the extraction of data from radiograms to diagnose cancer, predict outcomes or guide therapy.
“Radiology is one step ahead and shows what is possible with the emerging field of radiomics—the extraction of data from radiograms to diagnose cancer, predict outcomes or guide therapy (54–56).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [54] Grosu, 2021, Machine Learning-Based Differentiation of Benign and Premalignant Colorectal Polyps Detected with CT Colonography in an Asymptomatic Screening Population: A Proof-Of-Concept Study, Radiology source
Not checked in the free run.
- cites [55] Ligero, 2021, A CT-based Radiomics Signature is Associated with Response to Immune Checkpoint Inhibitors in Advanced Solid Tumors, Radiology source
Not checked in the free run.
- cites [56] Skawran, 2021, Can Magnetic Resonance Imaging Radiomics of the Pancreas Predict Postoperative Pancreatic Fistula?, Eur J Radiol source
Not checked in the free run.
May combine two claims.
PremisecitationThe same Hermsen et al. algorithm worked on histological samples from different centers, thereby addressing the issue of reproducibility.
“Most importantly, the authors proved that the same algorithm worked on histological samples from different centers, thereby addressing the issue of reproducibility.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [46] Hermsen, 2019, Deep Learning-Based Histopathologic Assessment of Kidney Tissue, J Am Soc Nephrol source
Not checked in the free run.
May combine two claims.
PremisecitationAutomated image analysis, feature recognition, data extraction and deep learning models are everyday reality for the tech giants but have only partially reached precision pathology.
“Automated image analysis, feature recognition, data extraction and deep learning models are everyday reality for the tech giants but have only partially reached precision pathology (51–53).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [51] Yang, 2019, Applying Deep Neural Network Analysis to High-Content Image-Based Assays, SLAS Discov source
Not checked in the free run.
- cites [52] Wulczyn, 2020, Deep Learning-Based Survival Prediction for Multiple Cancer Types Using Histopathology Images, PLoS One source
Not checked in the free run.
- cites [53] Noel, 2018, Peri-personal Space as a Prior in Coupling Visual and Proprioceptive Signals, Sci Rep source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningA more comprehensive AI-based decision model could enlarge the pool of transplantable organs and improve patient outcomes.
“On the one hand, this could bring new insights to potentially enlarge the pool of transplantable organs and, on the other, improve patient outcomes.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable). May combine two claims.
Interpretationnone givenThe true potential of AI in healthcare has yet to be fully exploited, and its application in solid organ transplantation is mostly under development.
“The true potential of AI in healthcare has yet to be fully exploited and its application in solid organ transplantation is mostly under development.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable). May combine two claims.
Interpretationnone givenImplementing AI into daily clinical practice is an ongoing challenge and the best strategy forward is unclear.
“Implementing AI into daily clinical practice is an ongoing challenge and the best strategy forward is unclear.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.
Interpretationnone givenAI is on a trajectory of exponential growth and has the potential to improve how we experience our lives and to extend life itself.
“AI is on a trajectory of exponential growth, and has the potential to improve how we experience our lives and to extend life itself.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationcitationMany other domains of medicine beyond transplantation could benefit from AI, including precision medicine, AI-assisted computer vision, augmented and virtual reality, and AI-assisted integration and collection of patients' records.
“Moreover, while this manuscript focuses on the use of AI in transplantation, many other domains could benefit from it.”
- Also stated in: § Conclusion: AI Current Pitfalls and Future Promises · plain
“Precision medicine (genetic-based solutions, drug discovery and development) (61), AI-assisted computer vision (62), augmented and virtual reality (63) and the AI-assisted integration and collection of patients’ records (64, 65) are just few examples of how AI can be applied to medicine.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [61] Bohr, 2020, The Rise of Artificial Intelligence in Healthcare Applications, Artif Intell Healthc source
Not checked in the free run.
- cites [62] Gurgitano, 2021, Interventional Radiology Ex-Machina: Impact of Artificial Intelligence on Practice, Radiol Med source
Not checked in the free run.
- cites [63] Wendler, 2021, How Molecular Imaging Will Enable Robotic Precision Surgery: The Role of Artificial Intelligence, Augmented Reality, and Navigation, Eur J Nucl Med Mol Imaging source
Not checked in the free run.
- Also stated in: § Conclusion: AI Current Pitfalls and Future Promises · plain
The paper relies on this without support.
Pre- and post-transplantation patient care requires complex decision-making.
“The pre- and post-transplantation patient care requires complex decision-making.”
The paper relies on this without support.
AI is still in its infancy and we lack validated algorithms that could accurately drive organ selection, predict potential rejections or attenuate postoperative complications.
“AI is still in its infancy and, so far, we lack validated algorithms that could accurately drive organ selection, predict potential rejections or attenuate postoperative complications.”
The paper relies on this without support.
In the last few decades, AI applications have already contributed to lower incidence of rejection, and fine-tuning of the transplantation and organ preservation processes.
“Nevertheless, in the last few decades, AI applications have already contributed to lower incidence of rejection, and fine-tuning of the transplantation and organ preservation processes.”
The paper relies on this without support.
AI has proven highly efficient in image processing.
“AI has proven highly efficient in image processing.”
The paper relies on this without support.
Trained pathologists are in short supply.
“Unfortunately, trained pathologists are in short supply.”
The paper relies on this without support.
Quick and reliable assessment of liver steatosis during procurement still presents a challenge.
“In liver transplantation, quick and reliable assessment of liver steatosis during procurement still presents a challenge.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In organ transplantation, AI could assist in matching donors with recipients efficiently, but ethical nuances such as patient preferences, medical histories, and urgency require human judgment.
“In organ transplantation, AI could assist in matching donors with recipients efficiently.However, ethical nuances such as patient preferences, medical histories, and urgency require human judgment [124], [125].”
From Ethical Framework for Harnessing the Power of AI in Healthcare and Beyond (2024) · cites this paper as [125]
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Sorted by citations
Ethical Framework for Harnessing the Power of AI in Healthcare and Beyond
Nasir, S., Khan, R. A., & Bai, S. (2024) · IEEE Access · doi:10.1109/access.2024.3369912 · Cited by 152 · see citing works
- Authors
- Peloso, A., Moeckli, B., Delaune, V., Oldani, G., Andres, A., & Compagnon, P.
- Affiliations
- University of Geneva (CH)
- Corresponding author
- Peloso, Andrea
- Venue
- Transplant International
- Publisher
- Frontiers Media SA
- Published
- 2022-07-04
- Volume
- 35
- Pages
- 10640-10640
- ISSN
- 0934-0874 (ISSN-L)
- 1432-2277
- PMC
- PMC9290190
- OpenAlex
- W4283792648
- Cited by
- 67
- References
- 61
- Citations by year
- 2026: 15 · 2025: 17 · 2024: 22 · 2023: 12 · 2022: 1
- FWCI
- 0.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Transplant International (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (acceptedVersion, cc-by)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
- Keywords
- artificial intelligence, solid organ transplantation, organ allocation algorithms, donor-recipient matching, transplant oncology, immunosuppression, graft survival, digital health
- MeSH terms
- Algorithms, Artificial Intelligence, Forecasting, Humans, Medical Oncology, Organ Transplantation
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Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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