{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T13:13:57Z","timestamp":1778159637710,"version":"3.51.4"},"reference-count":29,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background\/Objectives: Early transient endocrine dysfunction after simultaneous pancreas-kidney transplantation (SPK) frequently triggers urgent investigations to exclude thrombosis, pancreatitis, or rejection, yet many recipients recover during the index admission. We tested whether pre-transplant day zero (D0) serum Fourier-transform infrared spectroscopy (FTIRS) captures a biochemical fingerprint associated with a Start&amp;Stop trajectory (initial insulin independence followed by transient dysfunction with recovery). Methods: In a single-center retrospective case-control study nested within 104 consecutive SPK recipients with available D0 serum, 12 Start&amp;Stop cases were matched 1:1 to 12 No-Stop controls. Serum FTIR spectra went through structured quality control and standardized preprocessing. A Na\u00efve Bayes classifier with Fast Correlation-Based Filter (FCBF) feature selection was evaluated using leave-one-out cross-validation (LOOCV) and label-permutation analysis. Results: Under LOOCV, the primary FTIRS model (Savitzky-Golay second derivative; 600\u2013900 and 2800\u20133400 cm\u22121) achieved excellent discrimination (ROC-AUC 1.00) with accuracy 0.958 and F1 score 0.958. Discrimination collapsed under label permutation (ROC-AUC 0.461), supporting a non-random label-spectrum association. Discriminant information mapped mainly to carbohydrate\/glycoprotein-associated bands (~946\u20131161 cm\u22121), protein structural contributions near the amide III region (~1300 cm\u22121), and lipid\/protein stretching modes (~2865\u20133163 cm\u22121), consistent with a multicomponent systemic biochemical state. Conclusions: In this exploratory matched case-control cohort, pre-transplant D0 serum FTIRS signatures were associated with the subsequent Start&amp;Stop phenotype after SPK. These findings should be interpreted as recipient-side exploratory risk-stratification signals rather than clinically actionable decision tools. Larger multicenter validation in unselected cohorts, with standardized endpoint adjudication, preanalytical control, fully nested model development and inter-instrument harmonization, is required before clinical implementation or population-level risk calibration.<\/jats:p>","DOI":"10.3390\/life16050780","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:15:07Z","timestamp":1778156107000},"page":"780","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-Transplant Serum FTIRS Signatures as Predictive Biomarkers of Early Transient Pancreatic Graft Dysfunction in Simultaneous Pancreas-Kidney Transplantation"],"prefix":"10.3390","volume":"16","author":[{"given":"Emanuel","family":"Vigia","sequence":"first","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Center, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"},{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"iNOVA4Health\u2014Advancing Precision Medicine, N\u00facleo de Investiga\u00e7\u00e3o em Doen\u00e7as Renais, Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Centro Cl\u00ednico Acad\u00e9mico de Lisboa, 1169-024 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8911-3380","authenticated-orcid":false,"given":"Lu\u00eds","family":"Ramalhete","sequence":"additional","affiliation":[{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"iNOVA4Health\u2014Advancing Precision Medicine, N\u00facleo de Investiga\u00e7\u00e3o em Doen\u00e7as Renais, Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Blood and Transplantation Center of Lisbon, Instituto Portugu\u00eas do Sangue e da Transplanta\u00e7\u00e3o, Alameda das Linhas de Torres, n\u25e6 117, 1769-001 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9369-6486","authenticated-orcid":false,"given":"R\u00faben","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"ISEL\u2014Instituto Superior de Engenharia de Lisboa, Rua Conselheiro Em\u00eddio Navarro 1, 1959-007 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3408-0515","authenticated-orcid":false,"given":"Sofia","family":"Corado","sequence":"additional","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Center, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7049-6721","authenticated-orcid":false,"given":"In\u00eas","family":"Barros","sequence":"additional","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Center, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Chumbinho","sequence":"additional","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Center, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Nobre","sequence":"additional","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Center, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Carrelha","sequence":"additional","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Center, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Pico","sequence":"additional","affiliation":[{"name":"Gabinete Coordenador de Colheita e Transplanta\u00e7\u00e3o, Hospital S\u00e3o Jos\u00e9, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9 R. Jos\u00e9 Ant\u00f3nio Serrano, 1150-199 Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Gabinete Coordenador de Colheita e Transplanta\u00e7\u00e3o, Hospital S\u00e3o Jos\u00e9, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9 R. Jos\u00e9 Ant\u00f3nio Serrano, 1150-199 Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0528-2716","authenticated-orcid":false,"given":"Miguel Bigotte","family":"Vieira","sequence":"additional","affiliation":[{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Nephrology, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Magri\u00e7o","sequence":"additional","affiliation":[{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Nephrology, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patr\u00edcia","family":"Cotovio","sequence":"additional","affiliation":[{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Nephrology, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Caeiro","sequence":"additional","affiliation":[{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Nephrology, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00eas","family":"Aires","sequence":"additional","affiliation":[{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Nephrology, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cec\u00edlia","family":"Silva","sequence":"additional","affiliation":[{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal"},{"name":"Nephrology, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Pena","sequence":"additional","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Center, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00eds","family":"Bicho","sequence":"additional","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Center, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Jorge","sequence":"additional","affiliation":[{"name":"Nephrology, Curry Cabral Hospital, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, R. da Benefic\u00eancia 8, 1050-099 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5264-9755","authenticated-orcid":false,"given":"Cec\u00edlia R. C.","family":"Calado","sequence":"additional","affiliation":[{"name":"ISEL\u2014Instituto Superior de Engenharia de Lisboa, Rua Conselheiro Em\u00eddio Navarro 1, 1959-007 Lisbon, Portugal"},{"name":"Institute for Bioengineering and Biosciences (iBB), The Associate Laboratory Institute for Health and Bioeconomy-i4HB, Instituto Superior T\u00e9cnico (IST), Universidade de Lisboa (UL), Av. 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