A prognostic tool for individualized prediction of graft failure risk within ten years after kidney transplantation - Individual Prediction and Prevention of Risks of Immunosuppressive Therapies in Transplantation Access content directly
Journal Articles Journal of Transplantation Year : 2019

A prognostic tool for individualized prediction of graft failure risk within ten years after kidney transplantation

Abstract

Identification of patients at risk of kidney graft loss relies on early individual prediction of graft failure. Data from 616 kidney transplant recipients with a follow-up of at least one year were retrospectively studied. A joint latent class model investigating the impact of serum creatinine (Scr) time-trajectories and onset of de novo donor-specific anti-HLA antibody (dnDSA) on graft survival was developed. The capacity of the model to calculate individual predicted probabilities of graft-failure over time was evaluated in 80 independent patients. The model classified the patients in three latent classes with significantly different Scr time-profiles and different graft survivals. Donor age contributed to explain latent class membership. Additionally to the SCr classes, the other variables retained in the survival model were proteinuria measured one-year post-transplantation (HR=2.4, p=0.01), pre-transplant non-donor-specific antibodies (HR=3.3, p<0.001), dnDSA in patient who experienced acute rejection (HR=15.9, p=0.02). In the validation dataset, individual predictions of graft failure risk provided good predictive performances (sensitivity, specificity and overall accuracy of graft failure prediction at ten years were 77.7%, 95.8% and 85 %, respectively) for the 60 patients who had not developed dnDSA. For patients with dnDSA individual risk of graft failure was not predicted with a so good performance.
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Dates and versions

hal-02088955 , version 1 (29-04-2019)

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Danko Stamenic, Annick Rousseau, Marie Essig, Philippe Gatault, Matthias Buchler, et al.. A prognostic tool for individualized prediction of graft failure risk within ten years after kidney transplantation. Journal of Transplantation, 2019, ⟨10.1155/2019/7245142⟩. ⟨hal-02088955⟩
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