Liver supply immune state evaluation equipment, medium and computer

Abstract

The invention provides donor liver immune state evaluation equipment, a medium and a computer. The donor liver immune state evaluation equipment comprises a scoring module, a calculation module, a comparison module and an alarm module, by adopting the equipment disclosed by the invention, the comprehensive immune state of the donor liver implanted into the body of a recipient can be evaluated by integrating a plurality of indexes, the state of the recipient is pre-estimated before the recipient has adverse symptoms, the use dosage of immunological rejection drugs is controlled in advance, and the probability of adverse events such as rejection of the liver transplantation recipient is reduced.

Description

Technical Field

[0001] This invention relates to the field of liver transplantation assessment technology, and more specifically, to equipment, media, and computers for assessing the immune status of donor livers. Background Technology

[0002] The physiological state of the new liver after transplantation, whether it is rejection, anti-host disease, or immune equilibrium, is currently a hot topic in transplant immunology research. Studying changes in immune indicators in recipients after liver transplantation is used to diagnose the immune status of the new liver under the influence of anti-rejection drugs; the gold standard is donor liver biopsy. However, the recipient's immune status after transplantation is influenced by multiple factors, including the recipient's preoperative immunity, the use of immunosuppressants during and after surgery, and the immune response elicited by the donor liver. The combined effects of these multiple factors, stemming from the interactions between the donor, recipient, and exogenous drugs, make it impossible for clinicians to predict the post-transplant immune status of the donor liver based on a single or set of immune indicators. The donor liver's immune status affects the recovery of liver function and thus determines the dosage of anti-rejection drugs. Excessive dosage can lead to severe infection, while insufficient dosage results in donor liver rejection. The leading cause of death in liver transplant recipients during the perioperative period is uncontrollable infection, including bacteria, fungi, viruses, parasites, and even infections caused by normally resident microorganisms. The immune status of the donor liver is one of the important indicators reflecting its function. Currently, the methods for assessing this status all use a single immune indicator or a combination of several indicators, which cannot comprehensively and accurately reflect the immune status of the donor liver under the combined influence of drugs, immune shock from the recipient, and the donor's original immune status. Summary of the Invention

[0003] In view of the shortcomings of the existing technology, the purpose of this invention is to provide a device, medium and computer for assessing the immune status of donor livers, so as to overcome the above-mentioned disadvantages.

[0004] The above-mentioned technical objective of the present invention is achieved through the following technical solution: Firstly, a method for assessing the immune status of donor livers, comprising:

[0005] S1. Obtain the First Sign-Score (ISS) of the liver transplant recipient prior to liver transplantation. 术前 And the second ISS score of liver transplant recipients after liver transplantation. 术后 ;

[0006] S2, Calculate the first score ISS 术前 and the second rating ISS 术后 The difference is used to obtain the score difference (ISS). 差 Based on the syndrome differentiation of the liver transplant recipients, the corresponding score difference standard value (ISS) is selected. 差标准值 ; Calculate the score difference ISS 差 and the standard value of the score difference ISS差标准值 The difference is used to obtain the score actual difference (ISS). 实差 ;

[0007] S3. Based on the syndrome classification, select the corresponding exclusion threshold ISS. 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 The actual difference in the score ISS 实差 Respectively compared with the rejection real difference threshold ISS 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 A comparison is made to obtain a comparison result, which includes at least a first comparison result or a second comparison result;

[0008] S4. When the comparison result is the first comparison result, issue an rejection alarm signal; when the comparison result is the second comparison result, issue an infection alarm signal.

[0009] Secondly, equipment for assessing the immune status of donor livers includes:

[0010] The scoring module is used to obtain the Initial Sign-Score (ISS) of liver transplant recipients before undergoing liver transplantation. 术前 And the second ISS score of liver transplant recipients after liver transplantation. 术后 ;

[0011] The calculation module is used to calculate the first score ISS. 术前 and the second rating ISS 术后 The difference is used to obtain the score difference (ISS). 差 Based on the syndrome differentiation of the liver transplant recipients, the corresponding score difference standard value (ISS) is selected. 差标准值 ; Calculate the score difference ISS 差 and the standard value of the score difference ISS 差标准值 The difference is used to obtain the score actual difference (ISS). 实差 ;

[0012] The comparison module is used to select the corresponding exclusion real difference threshold (ISS) based on the syndrome classification. 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 The actual difference in the score ISS 实差 Respectively compared with the rejection real difference threshold ISS 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 A comparison is made to obtain a comparison result, which includes at least a first comparison result or a second comparison result;

[0013] Alarm module: Used to issue an exclusion alarm signal when the comparison result is the first comparison result; and to issue an infection alarm signal when the comparison result is the second comparison result.

[0014] Thirdly, a computer-readable storage medium having a computer program stored thereon, which, when executed by a processor, implements the steps of the method described in the first aspect.

[0015] Fourthly, a computer device includes a memory and a processor, the memory storing a computer program, and the processor executing the computer program to implement the steps of the method described in the first aspect.

[0016] In summary, the present invention has the following beneficial effects: This application provides a device for assessing the immune status of donor livers; using the device of the present invention, multiple indicators can be used to assess the overall immune status of the donor liver in the liver transplant recipient, and the patient's condition can be predicted before adverse symptoms appear, allowing for early control of the dosage of immune rejection drugs and avoiding the probability of adverse reactions in liver transplant recipients. Attached Figure Description

[0017] Figure 1 This is a flowchart of the donor liver immune status assessment method of the present invention;

[0018] Figure 2 This is a structural diagram of the liver donor immune status assessment device in an embodiment of the present invention;

[0019] Figure 3 This is an internal structural diagram of the computer device in an embodiment of the present invention;

[0020] Figure 4 This is a schematic diagram of set partitioning in an embodiment of the present invention;

[0021] In the diagram: 1. Scoring module; 2. Calculation module; 3. Comparison module; 4. Alarm module. Detailed Implementation

[0022] To make the objectives, features, and advantages of the present invention more apparent and understandable, specific embodiments of the present invention will be described in detail below with reference to the accompanying drawings. Several embodiments of the present invention are shown in the drawings. However, the present invention can be implemented in many different forms and is not limited to the embodiments described herein.

[0023] In this application embodiment, "at least one" refers to one or more, and "more than one" refers to two or more. "And / or" describes the relationship between related objects, indicating that three relationships can exist. For example, A and / or B can represent the existence of A alone, the simultaneous existence of A and B, or the existence of B alone. A and B can be singular or plural. The character " / " generally indicates that the preceding and following related objects are in an "or" relationship. "At least one of the following" and similar expressions refer to any combination of these items, including any combination of single or plural items. For example, at least one of a, b, and c can represent: a, b, c, ab, ac, bc, or abc, where a, b, and c can be single or multiple.

[0024] Those skilled in the art will recognize that the units and algorithm steps described in the embodiments disclosed herein can be implemented using electronic hardware, computer software, or a combination of electronic hardware and software. Whether these functions are implemented in hardware or software depends on the specific application and design constraints of the technical solution. Those skilled in the art can use different methods to implement the described functions for each specific application, but such implementation should not be considered beyond the scope of this application.

[0025] Those skilled in the art will understand that, for the sake of convenience and brevity, the specific working processes of the systems, devices, and units described above can be referred to the corresponding processes in the foregoing method embodiments, and will not be repeated here.

[0026] In the several embodiments provided in this application, any function, if implemented as a software functional unit and sold or used as an independent product, can be stored in a computer-readable storage medium. Based on this understanding, the technical solution of this application, in essence, or the part that contributes to the prior art, or a part of the technical solution, can be embodied in the form of a software product. This computer software product is stored in a storage medium and includes several instructions to cause a device (which may be a personal computer, server, or network device, etc.) to execute all or part of the steps of the methods described in the various embodiments of this application. The aforementioned storage medium includes various media capable of storing program code, such as USB flash drives, portable hard drives, read-only memory (ROM), random access memory (RAM), magnetic disks, or optical disks.

[0027] The above description is merely a specific embodiment of this application. Any variations or substitutions that can be easily conceived by those skilled in the art within the scope of the technology disclosed in this application should be included within the protection scope of this application. The protection scope of this application should be determined by the protection scope of the claims.

[0028] The present invention will now be described in detail with reference to the accompanying drawings and embodiments.

[0029] Example 1

[0030] To facilitate understanding of this technical solution, the existing liver transplantation process is first described: In liver transplantation surgery, the donor liver must first be completely removed from the donor's body. After this process, the donor liver must undergo blood perfusion to remove any residual blood components. The purpose of this operation is to prevent any immune cells or antigens that may be present in the donor blood from entering the recipient's body after transplantation and causing an immune conflict that could induce an immune response. After perfusion, the donor liver is immediately placed in a cryopreservation solution for cold ischemia preservation to maintain its physiological function and structural integrity, prolong its usability, and reduce the occurrence of reperfusion injury.

[0031] After a donor liver is transplanted into a recipient and blood flow is restored, the recipient's blood is reperfused into the donor liver. At this point, the donor liver is exposed to the recipient's immune system. Because the donor liver comes from another person, the human leukocyte antigen (HLA) and other foreign antigens on its surface may be recognized as "non-self substances" by the recipient's immune system, triggering an immune rejection response. This response is mainly mediated by immune effector cells such as T lymphocytes in the recipient's body and may lead to structural and functional damage to the graft.

[0032] To effectively prevent immune rejection, immunosuppressive therapy is typically administered to recipients before or immediately after liver transplantation. Immunosuppressive drugs (such as tacrolimus, cyclosporine A, prednisone, and mycophenolate mofetil) inhibit T-cell activation, proliferation, and the release of related inflammatory factors, thereby reducing the recipient's immune attack on the donor liver. However, the use of immunosuppressants must be strictly controlled within a precise dosage range. Insufficient dosage may fail to effectively suppress immune rejection, leading to acute or chronic rejection reactions; conversely, excessive dosage can significantly reduce the patient's immune capacity, making them more susceptible to infections from pathogens such as bacteria, viruses, and fungi, especially in the early postoperative period. Such infections can affect the lungs, abdominal cavity, and blood system, and in severe cases, even endanger life. Therefore, after liver transplantation, doctors usually dynamically adjust the immunosuppressive regimen based on the patient's specific condition (such as the intensity of the immune response, infection indicators, and blood drug concentration monitoring results) to ensure a relative balance between "suppressing rejection" and "avoiding infection," thereby improving transplant survival rates and long-term patient prognosis.

[0033] Currently, the clinical assessment of the immune status of donor livers mainly relies on routine liver function tests. However, these indicators have a certain lag in reflecting actual liver damage. Especially after the donor liver is implanted into the recipient, if an immune attack occurs, abnormal liver function usually only manifests when the immune damage has reached a certain level. Therefore, it reflects an indirect and delayed physiological response, making it difficult to reveal the early immune-mediated tissue damage process in a timely manner. The gold standard for studying changes in immune indicators after donor liver implantation to diagnose the immune status of the new liver under the influence of anti-rejection drugs is donor liver biopsy. However, donor liver biopsy causes trauma to liver transplant recipients and affects their quality of life. Therefore, how to detect and assess the immune status of the donor liver in vivo through the recipient's own immune status is an urgent problem to be solved.

[0034] To solve the above technical problems, such as Figure 1 As shown, this application provides a method for immune assessment in liver transplantation. To assess the immune status of donor liver transplant recipients, this application first requires the construction of an immune status assessment model.

[0035] To construct an immune status assessment model, it is first necessary to collect clinical case data. The screening criteria are as follows:

[0036] Inclusion criteria: a) Diagnosis of hepatitis B-related cirrhosis; b) Age 18–60 years; c) Liver cancer patients must meet the Milan Criteria. The Milan Criteria are an internationally recognized selection standard used clinically to assess the suitability of liver cancer patients for liver transplantation. Proposed in 1996 by Professor Mazzaferro's team at the University of Milan, Italy, the Milan Criteria specifically include: a single tumor with a maximum diameter ≤5cm, or a maximum of 3 tumor nodules, each with a diameter ≤3cm; no invasion of major blood vessels (such as the portal vein or hepatic vein); and no extrahepatic metastasis.

[0037] Exclusion criteria: a) autoimmune liver disease; b) complicated by severe infection; c) underlying cardiovascular and cerebrovascular diseases; d) preoperative intake of other drugs that enhance, suppress, or regulate immunity.

[0038] like Figure 4The image shows a collection of 60 actual liver transplant cases. To ensure comparability of the immune status of liver transplant recipients, Western medicine can assess immune function by measuring multiple immune indicators such as the CD4+ / CD8+ ratio, NK cell ratio, and inflammatory factor levels. However, these indicators are mostly isolated biological parameters and cannot comprehensively reflect the overall immune status. Traditional Chinese medicine (TCM) syndrome differentiation offers a comprehensive assessment method. Based on the theory of syndrome differentiation and treatment, syndrome differentiation summarizes clinical information such as symptoms, tongue and pulse signs, forming functional classifications with etiological and pathogenesis characteristics, such as Qi deficiency syndrome and damp-heat syndrome. These syndromes can, to a certain extent, reflect the patient's deficiency or excess of vital energy, immune status, and internal imbalance. Compared to Western medical indicators, syndrome differentiation emphasizes a holistic, dynamic, and functional stratification approach. Therefore, all the above clinical case data can be classified according to TCM syndrome differentiation. The same syndrome type indicates a certain degree of similarity in the patients' physical condition; patients belonging to the same syndrome type share certain commonalities in symptom presentation, etiology, pathogenesis, and constitutional tendencies. Figure 4 As shown, based on the TCM syndrome differentiation of the cases, the cases are divided into a set of excess syndromes and a set of deficiency syndromes. The set of excess syndromes contains several liver transplant recipients with excess syndromes, while the set of deficiency syndromes contains several liver transplant recipients with deficiency syndromes.

[0039]

[0040] Table 1: Immune Status Assessment Table

[0041] Table 1 shows the scoring scale for liver transplant recipients. The total score obtained from Table 1 is denoted as the ISS score. For each recipient in the liver transplant case set, their immune status before liver transplantation was assessed using the indicators in Table 1 to obtain the first ISS score. 术前 After undergoing a liver transplant, the patient's immune status was assessed to obtain a second ISS score. 术后 For a given case, a higher ISS score in the above immune status assessment table indicates a stronger immune status and a greater likelihood of immune rejection; conversely, a lower ISS score indicates a weaker immune status and a higher risk of infection.

[0042] For a liver transplant recipient, the immune status of the donor liver is not entirely the same as that of the recipient. Therefore, the donor liver's immune status needs to be assessed as an independent individual. For the liver transplant recipient, the immune status before and after the transplant surgery is assessed separately. The difference between these two assessments can be considered as the combined effect of surgical trauma, the donor liver, and immunosuppressive drugs on the patient's immune status. The formula is as follows:

[0043] ISS 差 =ISS 术后 -ISS 术前 =ISS 手术 +ISS 供肝 +ISS 免疫药物 ;

[0044] The above formula specifically means: for liver transplant recipients, changes in their immune status (ISS) 差 The main sources are three aspects: ① the impact of donor liver transplantation on the recipient, i.e., ISS. 供肝 ② The impact of surgical trauma on liver transplant recipients, i.e., ISS 手术影响 ③ The effects of immunosuppressive drugs, i.e., ISS 免疫药物 .

[0045] Because the donor liver's blood and lymphatic tissue have been physically removed before implantation, the influence of the donor's immunity on the donor liver's immune status has been minimized. 供肝 It can directly reflect the current immune status of the donor liver itself. Therefore, changes in its immune status are related to ISS. 差 It can be approximated as a donor liver (ISS) 供肝 ), immunosuppressive drugs (ISS) 免疫药物 ) and surgical trauma (ISS) 手术 The comprehensive impact on liver transplant recipients.

[0046] For any two liver transplant recipients, such as the first recipient and the second recipient, calculate their immune status change score, i.e., ISS. 差1 and ISS 差2 Based on the foregoing, it can be concluded that:

[0047] ISS 差1 =ISS 手术1 +ISS 供肝1 +ISS 免疫药物1 ;

[0048] ISS 差2 =ISS 手术2 +ISS 供肝2 +ISS 免疫药物2 ;

[0049] Each recipient undergoes a similar liver transplant procedure, therefore the surgical trauma is considered similar, i.e., ISS. 手术1 Approximate to ISS 手术2 Equal; and because each receptor is treated with immunosuppressive therapy according to the same dosing standard (the dosage of the drug is calculated based on the recipient's weight), the immune effects on the recipient can be considered equivalent, i.e., ISS.免疫药物1 Approximate to ISS 免疫药物2 They are equal. The difference in immune status change scores between any two liver transplant recipients is denoted as ISS. 实差 Therefore, we have:

[0050] ISS 实差 =ISS 差1 -ISS 差2 =(ISS) 手术1 +ISS 供肝1 +ISS 免疫药物1 )-

[0051] (ISS 手术2 +ISS 供肝2 +ISS 免疫药物2 )≈ISS 供肝1 -ISS 供肝2 ;

[0052] Based on ISS 实差 As can be seen from the definition, ISS 实差 This indicates the difference in immune status of the donor liver in different recipients. For example, if the first recipient experiences immune rejection but the second recipient does not, then the difference can be determined by the ISS (immune status status) of the two recipients. 实差 This can represent the difference in immune status between two recipients receiving transplanted livers. Based on the above conclusions, if a standard donor liver immune status, i.e., standard ISS, can be determined... 差 , take any patient's ISS 差 With standard ISS 差 Calculate ISS 实差 Then based on ISS 实差 To determine whether the target patient is at risk of adverse events, and based on the prediction results, to provide accurate medication advice to liver transplant recipients in advance, so as to avoid immune rejection or infection symptoms in liver transplant recipients.

[0053] The standard steps for calculating the immune status of donor livers are as follows: Figure 4 As shown, the liver transplant recipient set is first divided into a set of excess syndromes and a set of deficiency syndromes based on syndrome differentiation. Since the patients in the excess and deficiency syndrome sets differ only in syndrome differentiation and not in the calculation process, this embodiment only describes the excess syndrome set. The excess syndrome set includes 30 liver transplant recipient cases. The difference in excess syndrome scores for these 30 cases is calculated, and then the average of these 30 difference in excess syndrome scores is calculated as the standard value for the change in immune status in the excess syndrome set, denoted as the standard value of the difference in excess syndrome scores (ISS). 实证评分差标准值Similarly, for the 30 liver transplant recipient cases in the deficiency syndrome set, the deficiency syndrome score difference of these 30 cases is first calculated, and then the average of these 30 deficiency syndrome score differences is calculated as the standard value of the change in immune status in the deficiency syndrome set, denoted as the standard value of the deficiency syndrome score difference (ISS). 虚证评分差标准值 .

[0054] The standard value is a benchmark for changes in immune status within the empirical set. Therefore, the score difference (ISS) for any patient in the set is... 差 Standardized difference between empirical scores and the empirical score (ISS) 实证评分差标准值 The difference between the two can be seen as the difference between the recipient's immune status and the average immune status of liver transplant patients. This difference is denoted as the Real Score Difference (ISS). 实差 For all 30 patients in the empirical set, the corresponding real score difference (ISS) can be calculated. 实差 Specifically, this includes: ISS 实差 =ISS 差 -ISS 实证评分差标准值 The same principle applies to the set of deficiency syndromes, where the actual score difference (ISS) of the 30 cases can be obtained. 实差 .

[0055] To further determine whether a patient will experience an immune rejection reaction or has a high risk of infection, it is necessary to establish standard values ​​for both immune rejection and infection risk. The specific steps are as follows:

[0056] Obtain the empirical rejection set, which includes several patients whose syndrome type is empirical and who experienced immune rejection after liver transplantation; such as... Figure 4 As shown in the example, the number of cases in the empirical exclusion set is 10. Based on the aforementioned steps, the actual score difference (ISS) for each of these 10 cases has been calculated. 实差 Calculate the actual difference (ISS) of these 10 scores. 实差 The absolute value of the 10 absolute values ​​is then calculated, and the average of these 10 absolute values ​​is denoted as the empirical exclusion threshold (ISS). 实证排斥实差阈值 Similarly, for the seven cases included in the exclusion set of deficiency syndromes, their corresponding seven score differences (ISS) can also be obtained. 实差 The absolute value of the spurious evidence is calculated and its average value is denoted as the false evidence exclusion threshold (ISS). 虚证排斥实差阈值 The empirical exclusion threshold ISS can be used to determine the true difference. 实证排斥实差阈值 The threshold for exclusion of false evidence (ISS) 虚证排斥实差阈值 Collectively referred to as the exclusion real difference threshold (ISS) 排斥实差阈值 .

[0057] Obtain an empirical infection set, which includes several patients whose syndrome type is empirical and who developed infection symptoms after liver transplantation; such as... Figure 4As shown in the example, the number of cases in the empirical infection set is 8. Based on the aforementioned steps, the actual score difference (ISS) for these 8 cases has been calculated. 实差 Calculate the actual difference (ISS) of these 8 scores. 实差 The absolute value of each of the eight absolute values ​​is calculated, and then the average of these eight absolute values ​​is recorded as the empirical infection threshold (ISS). 实证感染实差阈值 Similarly, for the 15 cases included in the set of cases with deficiency syndrome, we can also obtain their corresponding 15 score differences (ISS). 实差 And calculate their average value, which is recorded as the false infection threshold ISS. 虚证感染实差阈值 The empirical infection difference threshold ISS can be used. 实证感染实差阈值 The threshold for the difference between false and true infection (ISS) 虚证感染实差阈值 Collectively referred to as the infection real difference threshold (ISS) 感染实差阈值 .

[0058] Based on the aforementioned ISS scoring criteria, it is known that the ISS score is positively correlated with the immune status of the target being assessed. For the recipient, a higher ISS score indicates a stronger immune status. Similarly, if the donor liver in the recipient's body is considered as a separate individual, its ISS score (i.e., the ISS difference) is... 差 The higher the ISS score, the stronger the immune status, and the more difficult it is for the recipient to control the donor liver; the ISS score (i.e., the ISS score difference) is also important. 差 The lower the level of the liver, the weaker the immune status, and the easier it is for the recipient to control the donor liver.

[0059] Based on the foregoing, the actual difference represents the discrepancy between the donor liver and the average immune status. Therefore, in the subsequent prediction of donor liver immune status, it is only necessary to compare the patient's immune status with the corresponding threshold, i.e., to assess and predict the patient's donor liver immune status, thereby adjusting treatment methods in advance to avoid serious damage to the donor liver. In summary, the model for assessing the immune status of the donor liver in a liver transplant recipient has been established. For details on how to assess the donor liver immune status in a liver transplant recipient, please refer to subsequent content.

[0060] The specific steps for assessing the immune status of a liver transplant recipient's donor liver are as follows:

[0061] S1. It is necessary to obtain the liver transplant recipient's First Sign-Score (ISS) prior to the liver transplant. 术前 And the second ISS score of liver transplant recipients after liver transplantation. 术后 ;

[0062] S2, Calculate the first score ISS 术前 and the second rating ISS 术后 The difference is used to obtain the score difference (ISS). 差Based on the syndrome differentiation of the liver transplant recipients, the corresponding score difference standard value (ISS) is selected. 差标准值 When the syndrome classification is empirical, the empirical score difference standard value (ISS) is selected. 实证评分差标准值 When the syndrome type is classified as a deficiency syndrome, the standard value of the deficiency syndrome score difference (ISS) is selected. 虚证评分差标准值 Calculate the score difference ISS. 差 and the standard value of the score difference ISS 差标准值 The difference is used to obtain the score actual difference (ISS). 实差 ;

[0063] S3. Based on the syndrome classification, select the corresponding exclusion threshold ISS. 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 When the syndrome classification is empirical, the empirical exclusion threshold (ISS) is selected. 实证排斥实差阈值 And the empirical infection difference threshold ISS 实证感染实差阈值 When the syndrome type is classified as a false syndrome, the false syndrome exclusion threshold ISS is selected. 虚证排斥实差阈值 And the threshold for the difference between false and true infection (ISS) 虚证感染实差阈值 The actual difference in the score ISS 实差 Respectively compared with the rejection real difference threshold ISS 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 The comparison results are obtained by making comparisons.

[0064] The specific comparison process is as follows: Obtain the actual difference in scores (ISS). 实差 The absolute value of is denoted as |ISS 实差 |;

[0065] First, |ISS 实差 |With ISS 排斥实差阈值 Compare; if |ISS 实差 | <ISS 排斥实差阈值 Furthermore, the ISS of liver transplant recipients 实差 If the value is less than 0, it is predicted that the donor liver in this case has a low immune status at this time point, and may be attacked by the recipient's immune system, making it prone to rejection. Therefore, it is necessary to increase the amount of anti-rejection drugs.

[0066] If |ISS 实差 |>ISS 排斥实差阈值 Furthermore, the ISS of liver transplant recipients 实差 If the value is greater than 0, the donor liver itself has a strong immune response and is in an immune-activated state, which may lead to an immune rejection reaction where the donor liver rejects the recipient.

[0067] Both of the above situations fall under the category of immune rejection. The above comparison results are recorded as the first comparison result. When the comparison module 3 obtains the above two results, it indicates that the receptor may have two extreme immune damages in opposite directions, and the alarm module 4 needs to issue a rejection alarm signal in a timely manner.

[0068] And in between the two situations mentioned above, namely |ISS 实差 | <ISS 排斥实差阈值 Furthermore, the ISS of liver transplant recipients 实差 >0, and |ISS 实差 |>ISS 排斥实差阈值 Furthermore, the ISS of liver transplant recipients 实差 If the value is less than 0, the donor liver and recipient's immune systems are in relative balance, and the recipient is in a state of immune tolerance, so there is no need to adjust the anti-rejection medication. In this case, alarm module 4 does not need to issue a rejection alarm signal.

[0069] Then you also need to add |ISS 实差 |With ISS 感染实差阈值 Compare; if |ISS 实差 |>ISS 感染实差阈值 Furthermore, the ISS of liver transplant recipients 实差 If the value is >0, it is predicted that the donor liver's immune status at that time point is higher than the average level, while the recipient's own immune status is low, increasing the probability of infection, and antibiotics need to be adjusted.

[0070] The above situation is one in which the risk of infection is likely to occur. The above comparison result is recorded as the second comparison result. When the comparison module 3 obtains the above result, it means that the recipient may be at risk of infection, and the alarm module 4 needs to issue an infection alarm signal in a timely manner.

[0071] If |ISS 实差 | <ISS 感染实差阈值 Furthermore, the ISS of liver transplant recipients 实差 If the value is less than 0, the donor liver is in a state of excessive immunosuppression, which poses a risk of rejection and requires an increase in the dosage of anti-rejection drugs.

[0072] Although in the above situations, |ISS 实差 |is with ISS 感染实差阈值 The comparison is made, but in reality, an immune rejection reaction may occur. The above comparison result is recorded as the first comparison result. When the comparison module 3 obtains the above result, the alarm module 4 needs to issue a rejection alarm signal in a timely manner.

[0073] And in between, namely |ISS 实差 |>ISS 感染实差阈值 Furthermore, the ISS of liver transplant recipients 实差 <0, and |ISS 实差| <ISS 感染实差阈值 Furthermore, the ISS of liver transplant recipients 实差 If the value is >0, then the donor liver and recipient's immune systems are in balance, there is no risk of infection, and no medication adjustment is needed. In this case, alarm module 4 does not need to issue an alarm signal. The same logic applies to the relevant content in the set of false symptoms, which will not be elaborated upon in this application.

[0074] In summary, this embodiment provides a liver transplant immune assessment method. Based on this method, the immune status of the donor liver in the liver transplant recipient can be assessed from the overall immune status of the liver transplant recipient. Then, based on the assessment results, auxiliary treatment can be given to the liver transplant recipient to avoid the delayed onset of immune symptoms and avoid serious harm to the patient.

[0075] Example 2

[0076] Please see Figure 2 This embodiment provides a liver donor immune status assessment device, which includes:

[0077] Scoring module 1 is used to obtain the initial ISS score of liver transplant recipients before undergoing liver transplantation. 术前 And the second ISS score of liver transplant recipients after liver transplantation. 术后 ;

[0078] Calculation module 2 is used to calculate the first score ISS. 术前 and the second rating ISS 术后 The difference is used to obtain the score difference (ISS). 差 Based on the syndrome differentiation of the liver transplant recipients, the corresponding score difference standard value (ISS) is selected. 差标准值 ; Calculate the score difference ISS 差 and the standard value of the score difference ISS 差标准值 The difference is used to obtain the score actual difference (ISS). 实差 ;

[0079] Comparison module 3 is used to select the corresponding exclusion real difference threshold (ISS) based on the syndrome classification. 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 The actual difference in the score ISS 实差 Respectively compared with the rejection real difference threshold ISS 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 A comparison is made to obtain a comparison result, which includes at least a first comparison result or a second comparison result;

[0080] Alarm module 4: Used to issue an exclusion alarm signal when the comparison result is the first comparison result; and to issue an infection alarm signal when the comparison result is the second comparison result.

[0081] Specific limitations regarding the equipment for assessing the immune status of donor livers can be found in the limitations of the methods for assessing the immune status of donor livers mentioned above, and will not be repeated here. Each module in the aforementioned equipment for assessing the immune status of donor livers can be implemented entirely or partially through software, hardware, or a combination thereof. These modules can be embedded in the processor of a computer device in hardware form or independent of the processor, or stored in the memory of a computer device in software form, so that the processor can call and execute the corresponding operations of each module.

[0082] Those skilled in the art will understand that Figure 2 The structure shown is merely a block diagram of a portion of the structure related to the present application and does not constitute a limitation on the present application. The specific liver immune status assessment device may include more or fewer components than shown in the figure, or combine certain components, or have different component arrangements.

[0083] Example 3

[0084] A computer-readable storage medium having a computer program stored thereon, which, when executed by a processor, implements the method for assessing the immune status of donor livers as described in Example 1.

[0085] Example 4

[0086] In one embodiment, a computer device is provided, which may be a server, and its internal structure diagram may be as follows: Figure 3 As shown. The computer device includes a processor, memory, network interface, and database connected via a system bus. The processor provides computing and control capabilities. The memory includes a non-volatile storage medium and internal memory. The non-volatile storage medium stores the operating system, computer programs, and database. The internal memory provides an environment for the operation of the operating system and computer programs in the non-volatile storage medium. When the computer program is executed by the processor, it implements the liver donor immune status assessment method as described in Embodiment 1.

[0087] Those skilled in the art will understand that Figure 3 The structure shown is merely a block diagram of a portion of the structure related to the present application and does not constitute a limitation on the computer device to which the present application is applied. Specific computer devices may include more or fewer components than those shown in the figure, or combine certain components, or have different component arrangements.

[0088] Example 5

[0089] Furthermore, this application also provides further supplements to the construction process of the evaluation model in Embodiment 1.

[0090] Specifically, when identifying whether a patient is likely to experience an immune rejection reaction or develop infection symptoms based on the ISS infection threshold or the ISS rejection threshold, it is first necessary to determine the rejection threshold (ISS). 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 These two thresholds are indeed correlated with adverse symptoms. In this embodiment, a t-validation method is provided to validate these two thresholds.

[0091] To verify the empirical exclusion threshold, the empirical set was first divided into two parts: the first part was the empirical exclusion set, which included 10 people; the second part was the empirical non-exclusion set, which included 8 people from the empirical infection set and 12 people from the empirical normal set, for a total of 20 people.

[0092] The formula for calculating t-validation is as follows:

[0093]

[0094] in, The ISS represents the real difference in ratings among the 10 individuals in the empirical exclusion set. 实差 The average value; The real difference (ISS) of the ratings of 20 individuals in the empirical non-exclusion set. 实差 The average value; The ISS represents the real difference in ratings among the 10 individuals in the empirical exclusion set. 实差 The variance; The real difference (ISS) of the ratings of 20 individuals in the empirical non-exclusion set. 实差 The variance of n1; n1 represents the number of samples in the empirical exclusion set, which is 10 people; n2 represents the number of samples in the empirical non-exclusion set, which is 20 people.

[0095] The p-value is calculated using statistical software. If p < 0.05, it indicates a significant difference between the two group means, which proves that the actual difference between adverse events and the score ISS is negligible. 实差 There is a correlation, therefore, based on the actual difference in the rejection score ISS... 实差 The calculated average value can be used as a threshold to predict related events. In this embodiment, the calculation process of the p-value is prior art and will not be described in detail in this application.

[0096] Similarly, to verify the empirical infection difference threshold, the empirical set is first divided into two parts: the first part is the empirical infection set, which contains 8 people; the second part is the empirical non-infected set, which specifically includes 10 people from the empirical exclusion set and 12 people from the empirical normal set, for a total of 22 people.

[0097] To verify the threshold for rejection of false evidence, the set of false evidence was first divided into two parts: the first part was the set of false evidence rejection, which included 7 people; the second part was the set of false evidence non-rejection, which included 15 people from the set of false evidence infection and 8 people from the set of false evidence normal, for a total of 23 people.

[0098] To verify the threshold difference between false infection and actual infection, the set of false cases was first divided into two parts. The first part was the set of false infection, which included 15 people. The second part was the set of false non-infection, which included 7 people from the set of false rejection and 8 people from the set of false normal, for a total of 15 people.

[0099] To validate the constructed model, after calculating the corresponding thresholds, it is necessary to collect data from several liver transplant recipients. Based on the symptom classification of liver transplant recipients, the immune status of liver transplant recipients is assessed to predict their immune status. No additional intervention or treatment is given to the liver transplant recipients. The results are then observed to see if immune rejection or infection symptoms occur, and compared with the predicted results to verify the reliability of the model.

[0100] Example 6

[0101] Furthermore, based on Example 1, this example provides a method for assessing the immune status of liver transplant recipients. Example 1 uses a single postoperative indicator assessment, specifically set on the first day after liver transplantation surgery, to make the first judgment on the recipient's immune status. Although modern immunosuppressive techniques (such as preoperative crossmatching and novel immunosuppressants) have significantly reduced the incidence of hyperacute rejection (within minutes to hours post-surgery), early activation of acute cellular rejection (ACR) may begin 24-72 hours post-surgery. The first day post-surgery is a critical period where the immune system and the transplanted liver face multiple challenges; the core purpose of assessing immune status at this time is to identify potential risks early and optimize initial immunosuppressive therapy.

[0102] Based on this, the immune status of liver transplant recipients on day 7 was further assessed, and the difference between the ISS score on day 7 and the preoperative ISS score was calculated to determine the recipient's immune status on day 7. Since acute cellular rejection (ACR) typically occurs 5-14 days post-surgery, peaking around day 7, when T-cell-mediated immune attack is fully activated, day 7 is a critical period for post-transplant immune homeostasis reconstitution and a high incidence of acute rejection. Therefore, immune assessment of liver transplant patients is also necessary.

[0103] Those skilled in the art will understand that all or part of the processes in the methods of the above embodiments can be implemented by a computer program instructing related hardware. The computer program can be stored in a non-volatile computer-readable storage medium, and when executed, it can include the processes of the embodiments of the above methods. Any references to memory, storage, databases, or other media used in the embodiments provided in this application can include non-volatile and / or volatile memory. Non-volatile memory can include read-only memory (ROM), programmable ROM (PROM), electrically programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM), or flash memory. Volatile memory can include random access memory (RAM) or external cache memory. By way of illustration and not limitation, RAM is available in various forms, such as static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), dual data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), synchronous link DRAM (SLDRAM), Rambus direct RAM (RDRAM), direct memory bus dynamic RAM (DRDRAM), and memory bus dynamic RAM (RDRAM), etc.

[0104] The technical features of the above embodiments can be combined in any way. For the sake of brevity, not all possible combinations of the technical features in the above embodiments are described. However, as long as there is no contradiction in the combination of these technical features, they should be considered to be within the scope of this specification.

[0105] The above description is merely a preferred embodiment of the present invention. The scope of protection of the present invention is not limited to the above embodiments. All technical solutions falling within the scope of the present invention's concept are within the scope of protection of the present invention. It should be noted that for those skilled in the art, any improvements and modifications made without departing from the principles of the present invention should also be considered within the scope of protection of the present invention.

Claims

1. Equipment for assessing the immune status of donor livers, including: The scoring module is used to obtain the Initial Sign-Score (ISS) of liver transplant recipients before undergoing liver transplantation. 术前 And the second ISS score of liver transplant recipients after liver transplantation. 术后 ; The calculation module is used to calculate the first score ISS. 术前 and the second rating ISS 术后 The difference is used to obtain the score difference (ISS). 差 Based on the syndrome differentiation of the liver transplant recipients, the corresponding score difference standard value (ISS) is selected. 差标准值 ; Calculate the score difference ISS 差 and the standard value of the score difference ISS 差标准值 The difference is used to obtain the score actual difference (ISS). 实差 ; The comparison module is used to select the corresponding exclusion real difference threshold (ISS) based on the syndrome classification. 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 The actual difference in the score ISS 实差 Respectively compared with the rejection real difference threshold ISS 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 A comparison is made to obtain a comparison result, which includes at least a first comparison result or a second comparison result; Alarm module: used to issue an exclusion alarm signal when the comparison result is the first comparison result; and to issue an infection alarm signal when the comparison result is the second comparison result.

2. The liver donor immune status assessment device according to claim 1, characterized in that, The syndrome differentiation specifically includes: excess syndrome and deficiency syndrome; The score difference standard value ISS 差标准值 Specifically, this includes: Empirical Scoring Difference Standard Value (ISS) 实证评分差标准值 Standard value of the difference between the score and the false evidence score (ISS) 虚证评分差标准值 ; The exclusion real difference threshold ISS 排斥实差阈值 Specifically, this includes: Empirical Exclusion Threshold (ISS) 实证排斥实差阈值 And the threshold for exclusion of false evidence (ISS) 虚证排斥实差阈值 ; The infection real difference threshold ISS 感染实差阈值 Specifically, this includes: Empirical Infection Scale (ISS) 实证感染实差阈值 And the threshold for the difference between false and true infection (ISS) 虚证感染实差阈值 .

3. The liver donor immune status assessment device according to claim 2, characterized in that, Based on the syndrome differentiation of the liver transplant recipient, the corresponding score difference standard value (ISS) is selected. 差标准值 Specifically, it includes: When the syndrome classification is empirical, the empirical score difference standard value (ISS) is selected. 实证评分差标准值 When the syndrome type is classified as a deficiency syndrome, the standard value of the deficiency syndrome score difference (ISS) is selected. 虚证评分差标准值 ; Based on the syndrome classification, the corresponding exclusion real difference threshold (ISS) is selected. 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 Specifically, it includes: When the syndrome classification is empirical, the empirical exclusion threshold (ISS) is selected. 实证排斥实差阈值 And the empirical infection difference threshold ISS 实证感染实差阈值 ; When the syndrome type is classified as a false syndrome, the False Syndrome Exclusion Threshold (ISS) is selected. 虚证排斥实差阈值 And the threshold for the difference between false and true infection (ISS) 虚证感染实差阈值 .

4. The liver donor immune status assessment device according to claim 1, characterized in that, The empirical score difference standard value (ISS) 实证评分差标准值 The steps to obtain it are as follows: Obtain an empirical set, which includes several liver transplant recipients whose TCM syndrome classification is empirical. Calculate the empirical score difference among all liver transplant recipients in the empirical set. Specifically, the empirical score difference is the difference between the score of each liver transplant recipient in the empirical set before liver transplantation and the score after liver transplantation. Calculate the average of all empirical score differences in the empirical set, and denote it as the empirical score difference standard value (ISS). 实证评分差标准值 .

5. The liver donor immune status assessment device according to claim 1, characterized in that, The standard value of the false evidence scoring difference (ISS) 虚证评分差标准值 The steps to obtain it are as follows: Obtain a set of deficiency syndromes, which includes several liver transplant recipients whose TCM syndrome classification is deficiency syndrome; Calculate the difference in deficiency syndrome scores for all liver transplant recipients in the deficiency syndrome set. Specifically, the difference in deficiency syndrome scores is the difference between the scores of each liver transplant recipient in the deficiency syndrome set before and after liver transplantation. Calculate the average of all false evidence score differences in the set of false evidence, and denote it as the standard value of false evidence score difference (ISS). 虚证评分差标准值 .

6. The liver donor immune status assessment device according to claim 1, characterized in that, The exclusion real difference threshold ISS 排斥实差阈值 The steps to obtain it are as follows: Obtain the rejection set; the rejection set belongs to the set of actual adverse symptoms or the set of inferential adverse symptoms, and the rejection set includes several liver transplant recipients who have experienced immune rejection. Obtain the actual difference in scores for each liver transplant recipient in the rejection set; Calculate the average of the absolute values ​​of all score real differences in the exclusion set, and denote it as the exclusion real difference threshold ISS. 排斥实差阈值 .

7. The liver donor immune status assessment device according to claim 1, characterized in that, The infection real difference threshold ISS 感染实差阈值 The steps to obtain it are as follows: Obtain an infection set; the infection set belongs to either the set of actual adverse symptoms or the set of false adverse symptoms, and the infection set includes several liver transplant recipients who have developed infection symptoms; Obtain the score difference of each liver transplant recipient in the infection set; The average of the absolute values ​​of all score real differences in the infection set is calculated and denoted as the infection real difference threshold (ISS). 感染实差阈值 .

8. The liver donor immune status assessment device according to claim 2, characterized in that, The actual difference in the score ISS 实差 Respectively compared with the rejection real difference threshold ISS 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 The comparison results are obtained by making comparisons, specifically including: Obtain the actual difference in the score ISS 实差 The absolute value of is denoted as |ISS 实差 |; When|ISS 实差 | <ISS 排斥实差阈值 ISS 实差 <0; or, |ISS 实差 |>ISS 排斥实差阈值 ISS 实差 >0; or, |ISS 实差 | <ISS 感染实差阈值 ISS 实差 When <0, the comparison result is recorded as the first comparison result; When|ISS 实差 |>ISS 感染实差阈值 ISS 实差 If the result is greater than 0, then the comparison result is recorded as the second comparison result.

9. A computer-readable storage medium having a computer program stored thereon, characterized in that, When the computer program is executed by the processor, it implements a method for assessing the immune status of donor livers, the method specifically including: S1. Obtain the First Sign-Score (ISS) of the liver transplant recipient prior to liver transplantation. 术前 And the second ISS score of liver transplant recipients after liver transplantation. 术后 ; S2, Calculate the first score ISS 术前 and the second rating ISS 术后 The difference is used to obtain the score difference (ISS). 差 Based on the syndrome differentiation of the liver transplant recipients, the corresponding score difference standard value (ISS) is selected. 差标准值 ; Calculate the score difference ISS 差 and the standard value of the score difference ISS 差标准值 The difference is used to obtain the score actual difference (ISS). 实差 ; S3. Based on the syndrome classification, select the corresponding exclusion threshold ISS. 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 The actual difference in the score ISS 实差 Respectively compared with the rejection real difference threshold ISS 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 A comparison is made to obtain a comparison result, which includes at least a first comparison result or a second comparison result; S4. When the comparison result is the first comparison result, issue an rejection alarm signal; when the comparison result is the second comparison result, issue an infection alarm signal.

10. A computer device comprising a memory and a processor, wherein the memory stores a computer program, characterized in that, When the processor executes the computer program, it implements a method for assessing the immune status of donor livers, the method specifically including: S1. Obtain the First Sign-Score (ISS) of the liver transplant recipient prior to liver transplantation. 术前 And the second ISS score of liver transplant recipients after liver transplantation. 术后 ; S2, Calculate the first score ISS 术前 and the second rating ISS 术后 The difference is used to obtain the score difference (ISS). 差 Based on the syndrome differentiation of the liver transplant recipients, the corresponding score difference standard value (ISS) is selected. 差标准值 ; Calculate the score difference ISS 差 and the standard value of the score difference ISS 差标准值 The difference is used to obtain the score actual difference (ISS). 实差 ; S3. Based on the syndrome classification, select the corresponding exclusion threshold ISS. 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 The actual difference in the score ISS 实差 Respectively compared with the rejection real difference threshold ISS 排斥实差阈值 and the infection difference threshold ISS 感染实差阈值 A comparison is made to obtain a comparison result, which includes at least a first comparison result or a second comparison result; S4. When the comparison result is the first comparison result, issue an rejection alarm signal; when the comparison result is the second comparison result, issue an infection alarm signal.

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