May 26, 2023
Mayo Clinic transplant specialists feel confident that artificial intelligence (AI) will be a valuable tool to improve patient outcomes and save lives. Recent studies have shown promise in using AI to analyze large data sets to uncover important trends and patterns, according to Mark D. Stegall, M.D., a transplant surgeon and researcher at Mayo Clinic in Minnesota.
"Physicians once practiced medicine without CT scans and with only limited lab tests," says Dr. Stegall. "Now, these tools are not only commonplace, but they are also critical to treatment decisions. I predict AI also will become an important decision-making tool for physicians."
Here are five potential effects Mayo Clinic experts foresee AI having on patient and transplant outcomes.
1. Prevent the need for a transplant
Research efforts are underway at Mayo Clinic to use AI to detect organ failure earlier. AI also is powerful in detecting potential impacts of early interventions to delay or prevent organ failure and need for organ replacement therapies.
"Transplantation is something that helps patients live longer, but it can be filled with potential complications," says Rohan M. Goswami, M.D., a transplant cardiologist and director of heart transplant research at Mayo Clinic in Florida. "We strive to discover ways to help patients recover on their own and have better quality and quantity of life."
Dr. Goswami's research has focused on utilizing AI to predict the ability of certain medications and devices to prevent kidney failure and pulmonary hypertension, illustrated in a 2023 abstract published in The Journal of Heart and Lung Transplantation.
2. Improve the organ donor and recipient matching process
AI promises to improve the complex organ donor and recipient matching process by helping determine which donated organs would result in successful transplants. The results of a Mayo Clinic study published in Clinical Transplantation in 2022 demonstrated how an AI-based scoring system can analyze transplanted kidney biopsies to determine inflammation levels, a key indication of a transplanted kidney's health.
3. Increase organs usable for transplant
AI has the potential to determine which organs would benefit from perfusion systems and which are unsuitable for donation. Perfusion systems, along with other new technologies, have enabled the transplant community to expand the number of deceased donor organs available for transplant. These systems keep organs viable and allow organs to survive outside the body longer prior to transplant. Dr. Goswami and colleagues published a study on the application of this new technology to improve organ use rates in a 2022 issue of the International Journal of Scientific Research.
4. Prevent organ rejection
Organ rejection poses a significant challenge in transplant medicine. However, AI shows promise for identification of patients at highest risk of organ rejection, thus lowering morbidity. Mayo Clinic authors published a study in a 2023 issue of the European Heart Journal that indicated that electrocardiography held promise for prediction of low-grade rejection risk, potentially without a biopsy, for patients with heart transplants. Dr. Goswami and his colleagues also published data in a 2022 issue of The Journal of Heart and Lung Transplantation identifying high-risk patients using 12-lead echocardiography after transplant. This procedure may allow for closer follow-up for some patients, potentially decreasing post-transplant complications.
5. Improve post-transplant care
Transplant specialists could one day use AI to determine how a patient's body reacts to immunosuppressants and guide medication adjustments to administer only the minimum necessary dose. The 2022 article in The Journal of Heart and Lung Transplantation discusses the role of AI electrocardiography as a predictor of high- and at-risk patients post-heart transplant.
AI also has the potential to eliminate routine biopsy post-transplant.
Mayo Clinic transplant specialists stress that AI's success rests on quality data. They also explain that AI's role will not be to replace clinician expertise, but to offer another tool to ensure optimal patient care.
"We don't use information blindly and will not follow AI tools blindly," says Dr. Stegall. "One of the great hopes of AI decision tools is that they can help integrate many other tools, such as scans and labs, into a model that provides a fuller picture of the patient."
Disclaimer:
Mayo Clinic has an agreement with Lung Bioengineering to provide organ perfusion services. Dr. Goswami is a consultant for Abiomed but does not receive funding from Abiomed for research.
For more information
Ruiz J, et al. The Impact of Axillary Mechanical Circulatory Support in Patients Awaiting Heart Transplantation with Pulmonary Hypertension. The Journal of Heart and Lung Transplantation. 2023;42(suppl):S354.
Smith B, et al. Automated scoring of total inflammation in renal allograft biopsies. Clinical Transplantation. 2022;37:e14837.
Jang J, et al. Merging advance technology to improve outcomes in heart transplantation. International Journal of Scientific Research. 2022;11:26.
Adedinsewo D, et al. Non-invasive detection of cardiac allograft rejection among heart transplant recipients using an electrocardiogram based deep learning model. European Heart Journal. 2023;4:71.
Morales JR, et al. Artificial intelligence 12 lead ECG based heart age estimation and 1-year outcomes after heart transplantation. The Journal of Heart and Lung Transplantation. 2022;41(suppl):S213.
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