An adjustable predictive score of graft survival in kidney transplant patients and the levels of risk linked to de novo donor-specific anti-HLA antibodies.

Aurélie Prémaud 1, * Matthieu Filloux 2, 3 Philippe Gatault 4 Antoine Thierry 5 Matthias Büchler 4 Eliza Munteanu 6 Pierre Marquet 7, 1 Marie Essig 1, 6 Annick Rousseau 1
* Auteur correspondant
1 PIST - Pharmacologie des Immunosuppresseurs et de la Transplantation
2 Service d'Immunologie et immunogénétique [CHU Limoges]
3 CRIBL - Contrôle de la Réponse Immune B et des Lymphoproliférations
4 Service néphrologie et immunologie clinique [CHU Tours]
5 Service de Néphrologie-Hémodialyse-Transplantation rénale [CHU Poitiers]
6 Service de Néphrologie, Dialyse, Transplantations [CHU Limoges]
7 Service de Pharmacologie, toxicologie et pharmacovigilance [CHU Limoges]
Abstract : Most predictive models and scores of graft survival in renal transplantation include factors known before transplant or at the end of the first year. They cannot be updated thereafter, even in patients developing donor-specific anti-HLA antibodies and acute rejection.We developed a conditional and adjustable score for prediction of graft failure (AdGFS) up to 10 years post-transplantation in 664 kidney transplant patients. AdGFS was externally validated and calibrated in 896 kidney transplant patients.The final model included five baseline factors (pretransplant non donor-specific anti-HLA antibodies, donor age, serum creatinine measured at 1 year, longitudinal serum creatinine clusters during the first year, proteinuria measured at 1 year), and two predictors updated over time (de novo donor-specific anti-HLA antibodies and first acute rejection). AdGFS was able to stratify patients into four risk-groups, at different post-transplantation times. It showed good discrimination (time-dependent ROC curve at ten years: 0.83 (CI95% 0.76-0.89).
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PLoS ONE, Public Library of Science, 2017, 12 (7), pp.e0180236. 〈10.1371/journal.pone.0180236〉
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Soumis le : mardi 27 juin 2017 - 10:35:42
Dernière modification le : vendredi 27 juillet 2018 - 15:04:02
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Aurélie Prémaud, Matthieu Filloux, Philippe Gatault, Antoine Thierry, Matthias Büchler, et al.. An adjustable predictive score of graft survival in kidney transplant patients and the levels of risk linked to de novo donor-specific anti-HLA antibodies.. PLoS ONE, Public Library of Science, 2017, 12 (7), pp.e0180236. 〈10.1371/journal.pone.0180236〉. 〈inserm-01547862〉

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