# Predicting post-transplant kidney function from pre-transplant biopsy and clinical biomarkers using a convolutional neural network

> **NIH NIH F32** · JOHNS HOPKINS UNIVERSITY · 2021 · $86,458

## Abstract

PROJECT SUMMARY/ABSTRACT
The need for transplantable kidneys far exceeds their availability with over 90,000 candidates currently
waitlisted but less than 22,000 transplants performed annually. Over 8,000 patients are removed from the
waitlist each year due to death or deterioration in health while awaiting an offer. Despite this critical need for
organs, nearly 20% of recovered kidneys are ultimately discarded. The most commonly reported reason for
discard is unfavorable histology on donor biopsy. These pre-transplant biopsies are performed in order to
assess the quality of the organ and are often used as a tool to predict post-implantation allograft performance.
Unfortunately, the prognostic significance of biopsy findings is controversial and there is growing concern
regarding the reliability and reproducibility of data derived from biopsy interpretation due to inter-pathologist
variability. Recent evidence demonstrates that recipient graft outcomes correlate only with donor biopsy
interpretation performed by an experienced renal pathologist. However, most transplant centers have no more
than a handful of dedicated expert renal pathologists; given that organ recovery often occurs at remote
hospitals late at night or on weekends, biopsies are usually interpreted by on-call pathologists without
dedicated training in renal histology. These providers tend to overestimate the severity of chronic lesions,
resulting in the inappropriate discard of otherwise acceptable organs.
Convolutional neural networks (CNNs), a machine learning technique, can equal or exceed human
performance in visual analysis tasks in an automated, objective fashion. We propose to leverage this new
technology to accomplish the following aims: (1) To develop a CNN that reliably and accurately predicts post-
transplant graft function from digitized procurement biopsy slides and donor and recipient metrics in the
Scientific Registry of Transplant Recipients (SRTR) dataset; (2) To compare the predictive accuracy of our
CNN to currently available donor risk scores; and (3) To qualitatively evaluate CNN adoptability, acceptability,
and utility by clinicians. These aims are highly feasible given our group's expertise in machine learning, kidney
transplantation, and analysis of SRTR data.
We hypothesize that we can build a CNN that provides transplant physicians with accurate pre-operative real-
time estimates of post-transplant graft success to help guide patient counseling. If the proposed aims are
achieved, feedback from our CNN could prevent the inappropriate discard of thousands of kidneys and
decrease waitlist mortality by increasing the number of transplants performed across the country. By
conducting this research, Dr. Eagleson will cultivate a skillset that includes national registry data analysis,
qualitative methods, and machine learning: important modern techniques that are rapidly becoming used
throughout medicine and will serve her well throughout her career as an indepen...

## Key facts

- **NIH application ID:** 10315165
- **Project number:** 1F32DK128977-01A1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Mackenzie Anne Eagleson
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $86,458
- **Award type:** 1
- **Project period:** 2021-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10315165

## Citation

> US National Institutes of Health, RePORTER application 10315165, Predicting post-transplant kidney function from pre-transplant biopsy and clinical biomarkers using a convolutional neural network (1F32DK128977-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10315165. Licensed CC0.

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