Thongprayoon C.Miao J.Jadlowiec C.Mao S.A.Mao M.Leeaphorn N.Kaewput W.Pattharanitima P.Valencia O.A.G.Tangpanithandee S.Krisanapan P.Suppadungsuk S.Nissaisorakarn P.Cooper M.Cheungpasitporn W.Mahidol University2024-02-082024-02-082023-01-01Renal Failure Vol.45 No.2 (2023)0886022Xhttps://repository.li.mahidol.ac.th/handle/20.500.14594/95559Background: Educational attainment significantly influences post-transplant outcomes in kidney transplant patients. However, research on specific attributes of lower-educated subgroups remains underexplored. This study utilized unsupervised machine learning to segment kidney transplant recipients based on education, further analyzing the relationship between these segments and post-transplant results. Methods: Using the OPTN/UNOS 2017–2019 data, consensus clustering was applied to 20,474 kidney transplant recipients, all below a college/university educational threshold. The analysis concentrated on recipient, donor, and transplant features, aiming to discern pivotal attributes for each cluster and compare post-transplant results. Results: Four distinct clusters emerged. Cluster 1 comprised younger, non-diabetic, first-time recipients from non-hypertensive younger donors. Cluster 2 predominantly included white patients receiving their first-time kidney transplant either preemptively or within three years, mainly from living donors. Cluster 3 included younger re-transplant recipients, marked by elevated PRA, fewer HLA mismatches. In contrast, Cluster 4 captured older, diabetic patients transplanted after prolonged dialysis duration, primarily from lower-grade donors. Interestingly, Cluster 2 showcased the most favorable post-transplant outcomes. Conversely, Clusters 1, 3, and 4 revealed heightened risks for graft failure and mortality in comparison. Conclusions: Through unsupervised machine learning, this study proficiently categorized kidney recipients with lesser education into four distinct clusters. Notably, the standout performance of Cluster 2 provides invaluable insights, underscoring the necessity for adept risk assessment and tailored transplant strategies, potentially elevating care standards for this patient cohort.MedicineArticleSCOPUS10.1080/0886022X.2023.22921632-s2.0-851796457491525604938087474