17 March 2026 : Original article
Development and Validation of a Machine Learning-Based Nomogram for Predicting Severe Pneumocystis jirovecii Pneumonia in Kidney Transplant Recipients
Shuo Wang AE 1,2*, Chuanyou Xia BF 1, Yuchong Zhu BC 1,2, Guanbao Tang D 1, Yunchao Wang C 1, Lingquan Meng F 1, Xiaoming Zhang D 1, Jianning Wang E 1, Jiwei Yang AE 1DOI: 10.12659/AOT.952235
Ann Transplant 2026; 31:e952235
Table 1 Baseline demographics and clinical laboratory characteristics in patients with PJP after kidney transplantation (training set and test set).
| Overall (n=169) | Training set (n=120) | Test set (n=49) | P value | |
|---|---|---|---|---|
| Sex, n(%) | 1.000 | |||
| Male | 138 (81.66) | 98 (81.67) | 40 (81.63) | |
| Female | 31 (18.34) | 22 (18.33) | 9 (18.67) | |
| Age (years), median (IQR) | 44 (36, 52) | 43 (36, 50) | 47 (37, 58) | 0.124 |
| Hypertension, n (%) | 153 (90.53) | 107 (89.17) | 46 (93.88) | 0.510 |
| BMI (kg/m), mean±SD | 22.56±3.91 | 22.36±3.85 | 23.06±4.04 | 0.288 |
| Donor type, n(%) | 0.414 | |||
| DCD | 148 (87.57) | 103 (85.83) | 45 (91.84) | |
| Living donor kidney | 21 (12.43) | 17 (14.17) | 4 (8.16) | |
| Induction therapy, n(%) | 0.388 | |||
| ATG | 93 (55.03) | 63 (52.50) | 30 (61.22) | |
| Other | 76 (44.97) | 57 (47.50) | 19 (38.78) | |
| Acute rejection, n(%) | 14 (8.28) | 10 (8.33) | 4 (8.16) | 1.000 |
| DGF, n(%) | 27 (15.98) | 20 (16.67) | 7 (14.29) | 0.879 |
| Time KT to PJP (months), mean±SD | 10 (5, 17) | 10 (5, 17.75) | 10 (6, 17) | 0.411 |
| CMV infection, n(%) | 70 (41.42) | 51 (42.50) | 19 (38.78) | 0.784 |
| BKV infection, n(%) | 21 (12.43) | 16 (13.33) | 5 (10.20) | 0.762 |
| WBC(×10/L), median (IQR) | 7.75 (5.54, 9.70) | 7.93 (5.62, 9.79) | 6.94 (5.52, 8.89) | 0.080 |
| N (×10/L), median (IQR) | 6.15 (4.57, 8.05) | 6.48 (4.53, 8.52) | 5.87 (4.59, 7.61) | 0.085 |
| CRP (mg/L), median (IQR) | 40.7 (20.05, 66.75) | 43.8 (20.93, 75.25) | 33.0 (17.40, 60.15) | 0.023 |
| Lym (×10/L), median (IQR) | 0.55 (0.37, 0.90) | 0.52 (0.36, 0.90) | 0.64 (0.40, 0.91) | 0.446 |
| PCT (ng/ml), median (IQR) | 0.19 (0.09, 0.89) | 0.27 (0.10, 1.05) | 0.14 (0.08, 0.35) | 0.030 |
| G_test(pg/ml), median (IQR) | 455.60 (165.30, 757.40) | 459.30 (183.85, 796.63) | 447.40 (158.90, 700.05) | 0.236 |
| CD4+ cell count, median (IQR) | 147.00 (94.00, 282.50) | 154.50 (94.50, 287.43) | 141.00 (90.67, 247.00) | 0.588 |
| CD8+ cell count, median (IQR) | 214.00 (132.50, 297.50) | 207.50 (129.75, 290.50) | 242.00 (140.50, 344.00) | 0.841 |
| Scr (μmol/L), median (IQR) | 174.00 (136.00, 233.50) | 174.50 (136.00, 236.50) | 167.00 (137.50, 228.50) | 0.947 |
| High-dose steroids, n(%) | 13 (7.69) | 8 (6.67) | 5 (10.20) | 0.642 |
| Hospital admission (days), median (IQR) | 23 (16, 31) | 22 (15.25, 30.75) | 25 (17, 32.5) | 0.245 |
| ICU admission, n(%) | 33 (19.53) | 24 (20.00) | 9 (18.37) | 0.807 |
| BMI – body mass index; SD – standard deviation; DCD – donation after circulatory determination of death; ATG – anti-thymocyte globulin; G_test – fungal (1→3)-b-D-glucan detection; CMV – cytomegalovirus; BKV – BK virus; WBC – white blood cell count; N – neutrophil count; CRP – C-reactive protein; Lym – lymphocyte count; PCT – procalcitonin; Scr – serum creatinine; DGF – delayed graft function; Time KT to PJP – PJP and kidney transplantation interval; High-dose steroids – methylprednisolone dose >40 mg/d; ICU – intensive care unit. | ||||