EXAM : Ex-vivo allograft monitoring dashboard for the analysis of hypothermic machine perfusion data in deceased-donor kidney transplantation

Article Article scientifique Article EXAM : Ex-vivo allograft monitoring dashboard for the analysis of hypothermic machine perfusion data in deceased-donor kidney transplantation eng 2024-12-18 author Schwab Simon 0000-0002-1588-2689 Swisstransplant, Bern, Switzerland.,Epidemiology, Biostatistics and Prevention Institute (EBPI) & Center for Reproducible Science (CRS), University of Zurich, Zurich, Switzerland. author Steck Hélène Swisstransplant, Bern, Switzerland. author Binet Françoise Isabelle Nephrology and Transplantation Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland. 32973 author Elmer Andreas Swisstransplant, Bern, Switzerland. author Ender Wolfgang Nephrology and Transplantation Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland. author Franscini Nicolas Ernesto Swisstransplant, Bern, Switzerland. 96555 author Haidar Fadi Division of Nephrology, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland. 960279 author Kuhn Christian Pierre 0000-0003-1346-3429 Nephrology and Transplantation Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland. 77940 author Sidler Daniel Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. author Storni Federico Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. author Krügel Nathalie Swisstransplant, Bern, Switzerland. author Immer Franz Swisstransplant, Bern, Switzerland. e0000691 10.1371/journal.pdig.0000691 39693311 2767-3170 PMC11654979 https://dx.plos.org/10.1371/journal.pdig.0000691 Deceased-donor kidney allografts are exposed to ischemic injury during ex vivo transport due to the lack of blood oxygen supply. Hypothermic machine perfusion (HMP) effectively reduces the risk of delayed graft function in kidney transplant recipients compared to standard cold storage. However, no free software implementation is available to analyze HMP data for state-of-the-art visualization and quality control. We developed the tool EXAM (ex-vivo allograft monitoring) as an interactive analytics dashboard. We wrote functions in the R programming language to read, process, and analyze HMP data from the LifePort kidney transporter (Organ Recovery Systems, USA). Time series for pressure, flow rate, organ resistance, and temperature are visualized, and relevant statistical indicators have been developed. We explain how data were processed, and indicators were calculated, and we present summary statistics for N = 255 kidney allografts receiving machine perfusion in Switzerland between 2020 and 2023. Median (interdecile range, IDR) of the main indicators were as follows: perfusion duration 5.18 hours (2.29-11.2), flow rate 110 ml/min (52.9-167), ice temperature 1.97°C (1.53-3.07), and perfusate temperature 6.68°C (5.58-8.36). We implemented the dashboard to identify issues, such as atypical perfusion parameters, high ice, or high perfusate temperature to inform transplant centers for quality assurance. In conclusion, EXAM is a free tool that statisticians and data scientists can quickly deploy to enable quality control at transplant organizations that use LifePort kidney transporters. An online viewer is available at https://data.swisstransplant.org/exam/. Dewey 616 56 Département de médecine 221 false PLOS digital health 3 12 8bc7d2fb-e643-4670-87c5-fe91fc728774 Article (Published version) Public journal.pdig.0000691.pdf 1558251 application/pdf CC BY-4.0 99d4094755769f722a802cc635b1437e17fd377f0924da4788e8f9264ee95fee openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

Title	Published in	Access level	OA Policy	Year	Views	Downloads

EXAM : Ex-vivo allograft monitoring dashboard for the analysis of hypothermic machine perfusion data in deceased-donor kidney transplantation	PLOS digital health			2024	58	201

Archive ouverte UNIGE

Franscini, Nicolas Ernesto