{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:27:23Z","timestamp":1785403643519,"version":"3.56.0"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundo de Financiamento da Investiga\u00e7\u00e3o (FFI) of Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, Centro de Investiga\u00e7\u00e3o","award":["FFI 39\/2026"],"award-info":[{"award-number":["FFI 39\/2026"]}]},{"award":["FFI 39\/2026"],"award-info":[{"award-number":["FFI 39\/2026"]}],"id":[{"id":"https:\/\/ror.org\/00k6r3f30","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Simultaneous pancreas\u2013kidney (SPK) transplantation can restore renal function and insulin independence, but non-technical pancreas graft dysfunction remains difficult to anticipate. Methods: We conducted an exploratory single-centre retrospective biomarker-modelling study to determine whether day-zero recipient serum Fourier-transform infrared (FTIR) spectra are associated with subsequent loss of insulin independence after SPK transplantation. Results: Among 104 screened recipients, 51 met predefined sample-availability, spectral-quality, data-linkage and endpoint-adjudication criteria; 30 maintained pancreas graft function and 21 developed dysfunction. Cases dominated by early technical surgical failure were excluded. Clinical-only, FTIR-only and FTIR\u2013clinical Na\u00efve Bayes models were evaluated using leave-one-out cross-validation with Fast Correlation-Based Filter feature selection. In locked-feature internal validation, the best FTIR-only model used second-derivative spectra with vector normalization and nine selected wavenumbers, achieving AUC 0.997 (95% CI 0.985\u20131.000) and accuracy 0.961 (95% CI 0.902\u20131.000). A fixed-feature permutation analysis exceeded label-randomized performance (empirical p = 0.001). The secondary Group 1 versus Group 3 analysis suggested discrimination of pancreas dysfunction despite preserved kidney function (AUC 0.992; accuracy 0.930). Conclusions: Given the small cohort, high-dimensional input, non-nested feature selection, selection-bias risk and absence of external validation, serum FTIR should be considered a candidate risk-enrichment platform requiring prospective multicentre validation.<\/jats:p>","DOI":"10.3390\/life16071054","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:03:56Z","timestamp":1782349436000},"page":"1054","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Day-Zero Serum FTIR Spectroscopy Identifies a Biochemical Signature Associated with Functional Pancreas Graft Dysfunction After Simultaneous Pancreas\u2013Kidney Transplantation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4525-9062","authenticated-orcid":false,"given":"Emanuel","family":"Vigia","sequence":"first","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Centre, 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-Advancing 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":[{"vocabulary":"crossref","role":"author"}]},{"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-Advancing 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 Centre of Lisbon, Instituto Portugu\u00eas do Sangue e da Transplanta\u00e7\u00e3o, Alameda das Linhas de Torres, n.\u00ba 117, 1769-001 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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-Instituto Superior de Engenharia de Lisboa, Rua Conselheiro Em\u00eddio Navarro 1, 1959-007 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3408-0515","authenticated-orcid":false,"given":"Sofia","family":"Corado","sequence":"additional","affiliation":[{"name":"Hepatobiliopancreatic and Transplantation Centre, Curry Cabral Hospital, Unidade Local De Sa\u00fade De S\u00e3o Jos\u00e9, R. 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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"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15709","DOI":"10.3389\/ti.2025.15709","article-title":"Simultaneous Pancreas-Kidney Versus Kidney Transplant Alone: Real-World Outcomes in a Propensity-Matched Global Cohort","volume":"38","author":"Catarinella","year":"2025","journal-title":"Transpl. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1016\/j.transproceed.2022.03.059","article-title":"The 2022 International Pancreas Transplant Registry Report\u2014A Review","volume":"54","author":"Gruessner","year":"2022","journal-title":"Transpl. Proc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S138","DOI":"10.1016\/j.ajt.2025.01.021","article-title":"OPTN\/SRTR 2023 Annual Data Report: Pancreas","volume":"25","author":"Kandaswamy","year":"2025","journal-title":"Am. J. Transplant."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/ajt.16750","article-title":"First World Consensus Conference on Pancreas Transplantation: Part II-Recommendations","volume":"21","author":"Boggi","year":"2021","journal-title":"Am. J. Transplant."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/MOT.0b013e32834ee717","article-title":"Pancreas graft thrombosis: Causes, prevention, diagnosis, and intervention","volume":"17","author":"Farney","year":"2012","journal-title":"Curr. Opin. 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