Histology and Not Donor Specific Antibody Helps Predict 5-Year Kidney Transplant Failure Using 1 Year Post-Transplant Data
1Department of Transplant Surgery, Mayo Clinic, Rochester, MN
2Department of Nephrology, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
3School of Immunity and Infection, University of Birmingham, Birmingham, United Kingdom.
Meeting: 2015 American Transplant Congress
Abstract number: 34
Keywords: Graft failure, Kidney transplantation
Session Information
Session Name: Concurrent Session: Kidney Complications: Late Graft Failure
Session Type: Concurrent Session
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[4]: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 December 14, 2024.« Back to 2015 American Transplant Congress