搜索结果：Kidney international

Kidney Exchange Programmes (KEPs) facilitate the exchange of kidneys, and larger pools of recipient-donor pairs tend to yield proportionally more transplants, leading to the proposal of international KEPs (IKEPs). However, as studied by \citet{mincu2021ip}, practical limitations must be considered in IKEPs to ensure that countries remain willing to participate. Thus, we study IKEPs with country-specific parameters, represented by a tuple $Γ$, restricting the selected transplants to be feasible for the countries to conduct, e.g., imposing an upper limit on the number of consecutive exchanges within a country's borders. We provide a complete complexity dichotomy for the problem of finding a feasible (according to the constraints given by $Γ$) cycle packing with the maximum number of transplants, for every possible $Γ$. We also study the potential for countries to misreport their parameters to increase their allocation. As manipulation can harm the total number of transplants, we propose a novel individually rational and incentive compatible mechanism $\mathcal{M}_{\text{order}}$. We first give a theoretical approximation ratio for $\mathcal{M}_{\text{order}}$ in terms of the number o

Motivated by the real-world problem of international kidney exchange (IKEP), recent literature introduced a generalized transferable utility matching game featuring a partition of the vertex set of a graph into players, and analyzed its complexity. We explore the non-transferable utility (NTU) variant of the game, where the utility of players is given by the number of their matched vertices. Our motivation for studying this problem is twofold. First, the NTU version is arguably a more natural model of the international kidney exchange program, as the utility of a participating country mostly depends on how many of its patients receive a kidney, which is non-transferable by nature. Second, the special case where each player has two vertices, which we call the NTU matching game with couples, is interesting in its own right and has intriguing structural properties. We study the core of the NTU game, which suitably captures the notion of stability of an IKEP, as it precludes incentives to deviate from the proposed solution for any possible coalition of the players. We prove computational complexity results about the weak and strong cores under various assumptions on the players. In par

The kidney exchange mechanism allows many patient-donor pairs who are otherwise incompatible with each other to come together and exchange kidneys along a cycle. However, due to infrastructure and legal constraints, kidney exchange can only be performed in small cycles in practice. In reality, there are also some altruistic donors who do not have any paired patients. This allows us to also perform kidney exchange along paths that start from some altruistic donor. Unfortunately, the computational task is NP-complete. To overcome this computational barrier, an important line of research focuses on designing faster algorithms, both exact and using the framework of parameterized complexity. The standard parameter for the kidney exchange problem is the number $t$ of patients that receive a healthy kidney. The current fastest known deterministic FPT algorithm for this problem, parameterized by $t$, is $O^\star\left(14^t\right)$. In this work, we improve this by presenting a deterministic FPT algorithm that runs in time $O^\star\left((4e)^t\right)\approx O^\star\left(10.88^t\right)$. This problem is also known to be W[1]-hard parameterized by the treewidth of the underlying undirected gra

In kidney exchange programmes patients with end-stage renal failure may exchange their willing, but incompatible living donors among each other. National kidney exchange programmes are in operation in ten European countries, and some of them have already conducted international exchanges through regulated collaborations. The exchanges are selected by conducting regular matching runs (typically every three months) according to well-defined constraints and optimisation criteria, which may differ across countries. In this work we give integer programming formulations for solving international kidney exchange problems, where the optimisation goals and constraints may be different in the participating countries and various feasibility criteria may apply for the international cycles and chains. We also conduct simulations showing the long-run effects of international collaborations for different pools and under various national restrictions and objectives.

Automatic segmentation of kidney and kidney tumour in Computed Tomography (CT) images is essential, as it uses less time as compared to the current gold standard of manual segmentation. However, many hospitals are still reliant on manual study and segmentation of CT images by medical practitioners because of its higher accuracy. Thus, this study focuses on the development of an approach for automatic kidney and kidney tumour segmentation in contrast-enhanced CT images. A method based on Convolutional Neural Network (CNN) was proposed, where a 3D U-Net segmentation model was developed and trained to delineate the kidney and kidney tumour from CT scans. Each CT image was pre-processed before inputting to the CNN, and the effect of down-sampled and patch-wise input images on the model performance was analysed. The proposed method was evaluated on the publicly available 2021 Kidney and Kidney Tumour Segmentation Challenge (KiTS21) dataset. The method with the best performing model recorded an average training Dice score of 0.6129, with the kidney and kidney tumour Dice scores of 0.7923 and 0.4344, respectively. For testing, the model obtained a kidney Dice score of 0.8034, and a kidney

We introduce partitioned matching games as a suitable model for international kidney exchange programmes, where in each round the total number of available kidney transplants needs to be distributed amongst the participating countries in a "fair" way. A partitioned matching game $(N,v)$ is defined on a graph $G=(V,E)$ with an edge weighting $w$ and a partition $V=V_1 \cup \dots \cup V_n$. The player set is $N = \{1, \dots, n\}$, and player $p \in N$ owns the vertices in $V_p$. The value $v(S)$ of a coalition $S \subseteq N$ is the maximum weight of a matching in the subgraph of $G$ induced by the vertices owned by the players in $S$. If $|V_p|=1$ for all $p\in N$, then we obtain the classical matching game. Let $c=\max\{|V_p| \; |\; 1\leq p\leq n\}$ be the width of $(N,v)$. We prove that checking core non-emptiness is polynomial-time solvable if $c\leq 2$ but co-NP-hard if $c\leq 3$. We do this via pinpointing a relationship with the known class of $b$-matching games and completing the complexity classification on testing core non-emptiness for $b$-matching games. With respect to our application, we prove a number of complexity results on choosing, out of possibly many optimal solu

The Kidney Exchange Problem is a prominent challenge in healthcare and economics, arising in the context of organ transplantation. It has been extensively studied in artificial intelligence and optimization. In a kidney exchange, a set of donor-recipient pairs and altruistic donors are considered, with the goal of identifying a sequence of exchange -- comprising cycles or chains starting from altruistic donors -- such that each donor provides a kidney to the compatible recipient in the next donor-recipient pair. Due to constraints in medical resources, some limits are often imposed on the lengths of these cycles and chains. These exchanges create a network of transplants aimed at maximizing the total number, $t$, of successful transplants. Recently, this problem was deterministically solved in $O^*(14.34^t)$ time (IJCAI 2024). In this paper, we introduce the representative set technique for the Kidney Exchange Problem, showing that the problem can be deterministically solved in $O^*(6.855^t)$ time.

To overcome incompatibility issues, kidney patients may swap their donors. In international kidney exchange programmes (IKEPs), countries merge their national patient-donor pools. We consider a recently introduced credit system. In each round, countries are given an initial ``fair'' allocation of the total number of kidney transplants. This allocation is adjusted by a credit function yielding a target allocation. The goal is to find a solution that approaches the target allocation as closely as possible, to ensure long-term stability of the international pool. As solutions, we use maximum matchings that lexicographically minimize the country deviations from the target allocation. We perform, for the first time, a computational study for a {\it large} number of countries. For the initial allocations we use two easy-to-compute solution concepts, the benefit value and the contribution value, and four classical but hard-to-compute concepts, the Shapley value, nucleolus, Banzhaf value and tau value. By using state-of-the-art software we show that the latter four concepts are now within reach for IKEPs of up to fifteen countries. Our experiments show that using lexicographically minimal

Cell nuclei instance segmentation is a crucial task in digital kidney pathology. Traditional automatic segmentation methods often lack generalizability when applied to unseen datasets. Recently, the success of foundation models (FMs) has provided a more generalizable solution, potentially enabling the segmentation of any cell type. In this study, we perform a large-scale evaluation of three widely used state-of-the-art (SOTA) cell nuclei foundation models (Cellpose, StarDist, and CellViT). Specifically, we created a highly diverse evaluation dataset consisting of 2,542 kidney whole slide images (WSIs) collected from both human and rodent sources, encompassing various tissue types, sizes, and staining methods. To our knowledge, this is the largest-scale evaluation of its kind to date. Our quantitative analysis of the prediction distribution reveals a persistent performance gap in kidney pathology. Among the evaluated models, CellViT demonstrated superior performance in segmenting nuclei in kidney pathology. However, none of the foundation models are perfect; a performance gap remains in general nuclei segmentation for kidney pathology.

This paper assesses whether using clinical characteristics in addition to imaging can improve automated segmentation of kidney cancer on contrast-enhanced computed tomography (CT). A total of 300 kidney cancer patients with contrast-enhanced CT scans and clinical characteristics were included. A baseline segmentation of the kidney cancer was performed using a 3D U-Net. Input to the U-Net were the contrast-enhanced CT images, output were segmentations of kidney, kidney tumors, and kidney cysts. A cognizant sampling strategy was used to leverage clinical characteristics for improved segmentation. To this end, a Least Absolute Shrinkage and Selection Operator (LASSO) was used. Segmentations were evaluated using Dice and Surface Dice. Improvement in segmentation was assessed using Wilcoxon signed rank test. The baseline 3D U-Net showed a segmentation performance of 0.90 for kidney and kidney masses, i.e., kidney, tumor, and cyst, 0.29 for kidney masses, and 0.28 for kidney tumor, while the 3D U-Net trained with cognizant sampling enhanced the segmentation performance and reached Dice scores of 0.90, 0.39, and 0.38 respectively. To conclude, the cognizant sampling strategy leveraging th

This paper presents a comprehensive review of the last two decades of research on Kidney Exchange Programs (KEPs), systematically categorizing and classifying key contributions to provide readers with a structured understanding of advancements in the field. The review highlights the evolution of KEP methodologies and lays the foundation for our contribution. We propose three mathematical models aimed at improving both the quantity and quality of kidney transplants. Model 1 maximizes the number of transplants by focusing on compatibility based on blood type and PRA, without additional constraints. Model 2 introduces a minimum Human Leukocyte Antigen (HLA) compatibility threshold to enhance transplant quality, though this leads to fewer matches. Model 3 extends the problem to a Multi-Agent Kidney Exchange Program (MKEP), pooling incompatible donor-recipient pairs across multiple agents, resulting in a higher number of successful transplants while ensuring fairness across agents. Sensitivity analyses demonstrate trade-offs between transplant quantity and quality, with Model 3 striking the optimal balance by leveraging multi-agent collaboration to improve both the number and quality of

The kidney paired donation (KPD) program provides an innovative solution to overcome incompatibility challenges in kidney transplants by matching incompatible donor-patient pairs and facilitating kidney exchanges. To address unequal access to transplant opportunities, there are two widely used fairness criteria: group fairness and individual fairness. However, these criteria do not consider protected patient features, which refer to characteristics legally or ethically recognized as needing protection from discrimination, such as race and gender. Motivated by the calibration principle in machine learning, we introduce a new fairness criterion: the matching outcome should be conditionally independent of the protected feature, given the sensitization level. We integrate this fairness criterion as a constraint within the KPD optimization framework and propose a computationally efficient solution using linearization strategies and column-generation methods. Theoretically, we analyze the associated price of fairness using random graph models. Empirically, we compare our fairness criterion with group fairness and individual fairness through both simulations and a real-data example.

In vitro models play a crucial role in advancing our understanding of biological processes, disease mechanisms, and developing screening platforms for drug discovery. Kidneys play an instrumental role in transport and elimination of drugs and toxins. However, despite the well-established patient-to-patient differences in kidney function and disease manifestation, progression and prognostic, few studies take this variability into consideration. In particular, the discrepancies between female and male biology warrants a better representation within kidney in vitro models. The omission of sex as a biological variable poses the significant risk of overlooking sex-specific mechanisms in health and disease and potential differences in drug efficacy and toxicity between males and females. This review aims to highlight the importance of incorporating sex dimorphism in kidney in vitro models by examining the sexual characteristics in the context of the current state-of-the-art. Furthermore, this review underscores opportunities for improving kidney models by incorporating sex-specific traits. Ultimately, this roadmap to incorporating sex-dimorphism in kidney in vitro models will facilitate

Automated segmentation of kidneys and kidney tumors is an important step in quantifying the tumor's morphometrical details to monitor the progression of the disease and accurately compare decisions regarding the kidney tumor treatment. Manual delineation techniques are often tedious, error-prone and require expert knowledge for creating unambiguous representation of kidneys and kidney tumors segmentation. In this work, we propose an end-to-end boundary aware fully Convolutional Neural Networks (CNNs) for reliable kidney and kidney tumor semantic segmentation from arterial phase abdominal 3D CT scans. We propose a segmentation network consisting of an encoder-decoder architecture that specifically accounts for organ and tumor edge information by devising a dedicated boundary branch supervised by edge-aware loss terms. We have evaluated our model on 2019 MICCAI KiTS Kidney Tumor Segmentation Challenge dataset and our method has achieved dice scores of 0.9742 and 0.8103 for kidney and tumor repetitively and an overall composite dice score of 0.8923.

In this paper, we investigated a C-arm tomographic technique as a new three dimensional (3D) kidney imaging method for nephrolithiasis and kidney stone detection over view angle less than 180o. Our C-arm tomographic technique provides a series of two dimensional (2D) images with a single scan over 40o view angle. Experimental studies were performed with a kidney phantom that was formed from a pig kidney with two embedded kidney stones. Different reconstruction methods were developed for C-arm tomographic technique to generate 3D kidney information including: point by point back projection (BP), filtered back projection (FBP), simultaneous algebraic reconstruction technique (SART) and maximum likelihood expectation maximization (MLEM). Computer simulation study was also done with simulated 3D spherical object to evaluate the reconstruction results. Preliminary results demonstrated the capability of our C-arm tomographic technique to generate 3D kidney information for kidney stone detection with low exposure of radiation. The kidney stones are visible on reconstructed planes with identifiable shapes and sizes.

Due to the shortage of available kidney organs for transplants, handling every donor kidney with utmost care is crucial to preserve the organ's health, especially during the organ supply chain where kidneys are prone to deterioration during transportation. Therefore, this research proposes a blockchain platform to aid in managing kidneys in the supply chain. This framework establishes a secure system that meticulously tracks the organ's location and handling, safeguarding the health from donor to recipient. Additionally, a machine-learning algorithm is embedded to monitor organ health in real-time against various metrics for prompt detection of possible kidney damage.

Kidney structures segmentation is a crucial yet challenging task in the computer-aided diagnosis of surgery-based renal cancer. Although numerous deep learning models have achieved remarkable success in many medical image segmentation tasks, accurate segmentation of kidney structures on computed tomography angiography (CTA) images remains challenging, due to the variable sizes of kidney tumors and the ambiguous boundaries between kidney structures and their surroundings. In this paper, we propose a boundary-aware network (BA-Net) to segment kidneys, kidney tumors, arteries, and veins on CTA scans. This model contains a shared encoder, a boundary decoder, and a segmentation decoder. The multi-scale deep supervision strategy is adopted on both decoders, which can alleviate the issues caused by variable tumor sizes. The boundary probability maps produced by the boundary decoder at each scale are used as attention to enhance the segmentation feature maps. We evaluated the BA-Net on the Kidney PArsing (KiPA) Challenge dataset and achieved an average Dice score of 89.65$\%$ for kidney structure segmentation on CTA scans using 4-fold cross-validation. The results demonstrate the effective

Renal cancer is one of the most prevalent cancers worldwide. Clinical signs of kidney cancer include hematuria and low back discomfort, which are quite distressing to the patient. Some surgery-based renal cancer treatments like laparoscopic partial nephrectomy relys on the 3D kidney parsing on computed tomography angiography (CTA) images. Many automatic segmentation techniques have been put forward to make multi-structure segmentation of the kidneys more accurate. The 3D visual model of kidney anatomy will help clinicians plan operations accurately before surgery. However, due to the diversity of the internal structure of the kidney and the low grey level of the edge. It is still challenging to separate the different parts of the kidney in a clear and accurate way. In this paper, we propose a channel extending and axial attention catching Network(CANet) for multi-structure kidney segmentation. Our solution is founded based on the thriving nn-UNet architecture. Firstly, by extending the channel size, we propose a larger network, which can provide a broader perspective, facilitating the extraction of complex structural information. Secondly, we include an axial attention catching(AAC

The automatic segmentation of kidney, kidney tumor and kidney cyst on Computed Tomography (CT) scans is a challenging task due to the indistinct lesion boundaries and fuzzy texture. Considering the large range and unbalanced distribution of CT scans' thickness, 2.5D ResUnet are adopted to build an efficient coarse-to-fine semantic segmentation framework in this work. A set of 489 CT scans are used for training and validation, and an independent never-before-used CT scans for testing. Finally, we demonstrate the effectiveness of our proposed method. The dice values on test set are 0.954, 0.792, 0.691, the surface dice values are 0.897, 0.591, 0.541 for kidney, tumor and cyst, respectively. The average inference time of each CT scan is 20.65s and the max GPU memory is 3525MB. The results suggest that a better trade-off between model performance and efficiency.