Date: Sunday, May 3, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 2:15pm-2:27pm
Location: Terrace IV
Introduction: The objective of this study was to validate the RISK score (Am J Kid D 2014; 63:643) for renal allograft failure using a different cohort and to assess if protocol biopsy data and anti-donor HLA antibody improved the model's ability to predict 5-year graft failure using 12 month data.
Methods: The validation cohort included solitary kidney transplant (Tx) recipients at Mayo Clinic, Rochester, MN between January 1999 and December 2008. Negative crossmatch Tx recipients (n=2159) were assessed for death-censored failure 5 years post-Tx. Risk scores were evaluated for prognostic utility (discrimination, calibration, and risk reclassification). Weighted regression coefficients for baseline, 12-month demographic and clinical predictor characteristics were used.
Results: Multivariate analysis identified glomerulitis and interstitial fibrosis and Class II DSA as associated with graft failure.
|Group Analysis||Number||Variable||Hazard Ratio||p-value|
|Histology Alone Group||981||g||2.53 (1.87, 3.42)||<0.001|
|ci||1.66 (1.35, 2.06)||<0.001|
|DSA Data Alone||622||Class II MFI<800||1.17 (0.34, 3.97)||0.001|
|Class II MFI>800||4.34 (1.98, 9.52)||0.001|
|Combined Histology and DSA||556||g||2.74 (1.77, 4.24)||<0.001|
|ci||1.90 (1.27, 2.85)||<0.001|
|Class II MFI<800||0.73 (0.16, 3.39)||0.002|
|Class II MFI>800||4.57 (1.89, 11.1)||0.003|
Conclusions: The RISK score was validated in a large cohort accurately identifying at-risk transplants and the addition of 1 year protocol biopsy data improves the assessment of risk, improving the classification in 30% of patients into high or low risk populations.
To cite this abstract in AMA style:Gonzales MMoreno, Bentall A, Stegall M, Borrows R. Histology and Not Donor Specific Antibody Helps Predict 5-Year Kidney Transplant Failure Using 1 Year Post-Transplant Data [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/histology-and-not-donor-specific-antibody-helps-predict-5-year-kidney-transplant-failure-using-1-year-post-transplant-data/. Accessed August 12, 2020.
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