Reply to: Machine learning-driven virtual biopsy system may increase organ discards at aggressive kidney transplant centers

Of their examine, Giorgakis et al. indicated increased false optimistic charges for average/extreme Banff lesions. Nevertheless, it’s essential to focus on the single-center retrospective nature of this examine, together with transplanted kidneys solely that haven’t been reassessed, which can have launched choice bias and restrict the generalizability of the findings, as in comparison with our worldwide multicenter examine comprising 17 facilities and 14,032 biopsies of transplanted and discarded kidneys, of which a subset of the biopsies had been reassessed by 4 consultants transplant pathologists (LDC, MPA, MR, JPDVH).

As well as, it ought to be famous that the AUC of the VBS (0.72–0.81) remained inside a suitable vary for ruling out extreme lesions. We agree that for high-risk predictions, a preimplantation biopsy could stay important to keep away from pointless organ discards. However, the first purpose of the VBS is to establish low-risk instances the place a preimplantation biopsy might be safely omitted as depicted within the Fig. 1.

This determine exhibits the supposed use and influence of the Digital Biopsy System on organ allocation course of. The primary a part of the determine exhibits the present organ allocation course of. The second half exhibits how this course of can be accelerated with the Digital Biopsy System, in the end main to higher graft outcomes.

This technique might lower chilly ischemia time and related issues, and subsequently contribute to fast-track organ allocation and improved transplant success charges (Fig. 1). Importantly, our examine didn’t intend to undermine the worth of biopsies in advanced instances however to supply an extra instrument for higher danger stratification and decision-making.