New challenges in renal transplantation include using biological information to devise a useful clinical test for discerning high- and low-risk patients for individual therapy and ascertaining the best combination and appropriate dosages of drugs. Based on a 20-genes signature from a microarray meta-analysis, with 46 operationally tolerant patients and 266 renal transplanted recipients with stable function, we applied the sparse Bolasso methodology to identify a minimal and robust combination of six genes and two demographic parameters as significantly associated with operational tolerance. This composite score of operational tolerance (cSoT) discriminates operationally tolerant patients with an AUC of 0.97 (95% CI= 0.94–1.00). The cSoT is not influenced by immunosuppressive treatment, center of origin, donor type, or post-transplant lymphoproliferative disorder history of patients. The cSoT is associated with de novo anti-HLA antibodies (p = 0.0011) and tolerance loss (p = 0.026). It was validated by quantitative PCR (AUC =0.84, 95% CI =0.65–1.00) and demonstrated specificity toward a model of tolerance induction. This score would allow clinicians to highlight immune tolerance status of recipients and may improve follow-up of patients, thus paving the way for individual therapy.

CITATION INFORMATION: Danger R, Chesneau M, Paul C, Guérif P, Durand M, Newell K, Kanaparthi S, Turka L, Soulillou J.-P, Houlgatte R, Giral M, Ramstein G, Brouard S. A Composite Score Associated with Spontaneous Operational Tolerance in Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

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