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algorithm, kidney transplant rejection

S M Kurian, E Velazquez, R Thompson, T Whisenant, S Rose, N Riley, F Harrison, T Gelbart, J J Friedewald, J Charrette, S Brietigam, J Peysakhovich, M R First, M M Abecassis, D R Salomon
We performed orthogonal technology comparisons of concurrent peripheral blood and biopsy tissue samples from 69 kidney transplant recipients who underwent comprehensive algorithm-driven clinical phenotyping. The sample cohort included patients with normal protocol biopsies and stable transplant (sTx) function (n = 25), subclinical acute rejection (subAR, n = 23), and clinical acute rejection (cAR, n = 21). Comparisons between microarray and RNA sequencing (RNA-seq) signatures were performed and demonstrated a strong correlation between the blood and tissue compartments for both technology platforms...
February 11, 2017: American Journal of Transplantation
Leila Shahmoradi, Mostafa Langarizadeh, Gholamreza Pourmand, Ziba Aghsaei Fard, Alireza Borhani
INTRODUCTION: One of the most important complications of post-transplant is rejection. Analyzing survival is one of the areas of medical prognosis and data mining, as an effective approach, has the capacity of analyzing and estimating outcomes in advance through discovering appropriate models among data. The present study aims at comparing the effectiveness of C5.0 algorithms, neural network and C&RTree to predict kidney transplant survival before transplant. METHOD: To detect factors effective in predicting transplant survival, information needs analysis was performed via a researcher-made questionnaire...
October 2016: Acta Informatica Medica: AIM
D Iwami, K Hotta, H Sasaki, T Hirose, H Higuchi, Y Takada, N Shinohara
BACKGROUND: De novo donor-specific antibody (dnDSA), especially against class II HLA, correlates with chronic active antibody-mediated rejection (CAAMR), which eventually leads to graft loss. It would be helpful if we could identify the patients at high risk of dnDSA development in terms of histocompatibility. Structure-based matching strategy assessing mismatched epitopes/eplets by comparing polymorphic amino acid sequences can predict the risk of development of dnDSA and CAAMR. However, it has not been evaluated in Japanese patients whose diversity in HLA is limited...
January 2017: Transplantation Proceedings
P F Halloran, J M Venner, K S Famulski
We annotated the top transcripts associated with kidney transplant rejection by p-value, either universal for all rejection or selective for T cell-mediated rejection (TCMR) or antibody-mediated rejection (ABMR; NCT01299168). We used eight class-comparison algorithms to interrogate microarray results from 703 biopsies, 205 with rejection. The positive comparators were all rejection, TCMR, or ABMR; the negative comparators varied from normal biopsies to all nonrejecting biopsies, including other diseases...
January 19, 2017: American Journal of Transplantation
Dong Zhu, Zexian Liu, Zhicheng Pan, Mengjia Qian, Linyan Wang, Tongyu Zhu, Yu Xue, Duojiao Wu
For end-stage renal diseases, kidney transplantation is the most efficient treatment. However, the unexpected rejection caused by inflammation usually leads to allograft failure. Thus, a systems-level characterization of inflammation factors can provide potentially diagnostic biomarkers for predicting renal allograft rejection. Serum of kidney transplant patients with different immune status were collected and classified as transplant patients with stable renal function (ST), impaired renal function with negative biopsy pathology (UNST), acute rejection (AR), and chronic rejection (CR)...
August 2016: Cell Biology and Toxicology
Amber O Molnar, Carl van Walraven, Eric McArthur, Dean Fergusson, Amit X Garg, Greg Knoll
BACKGROUND: Validation studies of acute kidney injury (AKI) diagnostic codes performed in the general population have shown poor sensitivity, but the accuracy of such codes in the kidney transplant population remains unknown. OBJECTIVE: The objective of this study is to determine the accuracy of AKI diagnostic codes in kidney transplant recipients. We hypothesized that the sensitivity of diagnostic codes would be significantly greater in the kidney transplant population since these patients are closely followed by nephrologists and are more likely to have serum creatinine measured...
2016: Canadian Journal of Kidney Health and Disease
Wai H Lim, Jeremy R Chapman, Patrick T Coates, Joshua R Lewis, Graeme R Russ, Narelle Watson, Rhonda Holdsworth, Germaine Wong
BACKGROUND AND OBJECTIVES: The current allocation algorithm for deceased donor kidney transplantation takes into consideration HLA mismatches at the ABDR loci but not HLA mismatches at other loci, including HLA-DQ. However, the independent effects of incompatibilities for the closely linked HLA-DQ antigens in the context of HLA-DR antigen matched and mismatched allografts are uncertain. We aimed to determine the effect of HLA-DQ mismatches on renal allograft outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the association between HLA-DQ mismatches and acute rejections in primary live and deceased donor kidney transplant recipients between 2004 and 2012 using adjusted Cox regression models...
May 6, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Felix S Seibert, Christian Rosenberger, Susanne Mathia, Robert Arndt, Wolfgang Arns, Huppertz Andrea, Nikolaos Pagonas, Frederic Bauer, Walter Zidek, Timm H Westhoff
BACKGROUND: Urinary calprotectin has recently been identified as a promising biomarker for the differentiation between prerenal and intrinsic acute kidney injury (AKI) in the nontransplant population. The present study investigates whether calprotectin is able to differentiate between these 2 entities in transplant recipients as well. METHODS: Urinary calprotectin was assessed by enzyme-linked immunosorbent assay in 328 subjects including 125 cases of intrinsic acute allograft failure, 27 prerenal graft failures, 118 patients with stable graft function, and 58 healthy controls...
February 2017: Transplantation
Paul Ostrom Kadota, Zahraa Hajjiri, Patricia W Finn, David L Perkins
Among kidney transplant recipients, the treatment of choice for acute T cell-mediated rejection (TCMR) with pulse steroids or antibody protocols has variable outcomes. Some rejection episodes are resistant to an initial steroid pulse, but respond to subsequent antibody protocols. The biological mechanisms causing the different therapeutic responses are not currently understood. Histological examination of the renal allograft is considered the gold standard in the diagnosis of acute rejection. The Banff Classification System was established to standardize the histopathological diagnosis and to direct therapy...
2015: Frontiers in Immunology
C Süsal, C Seidl, C Schönemann, F M Heinemann, T Kauke, P Gombos, R Kelsch, W Arns, U Bauerfeind, M Hallensleben, I A Hauser, G Einecke, R Blasczyk
One of the major tasks of histocompatibility and immunogenetics laboratories is the pretransplant determination of unacceptable antigen mismatches (UAM) in kidney transplant recipients. In this procedure, human leucocyte antigen (HLA) specificities are defined against which the patient has circulating alloantibodies that are expected to harm the transplanted organ. Using the information on UAM and the potential donor's complete HLA typing, prediction of the crossmatch result, the so called 'virtual crossmatch', is possible...
November 2015: Tissue Antigens
G J Dreyer, A C Hemke, M E J Reinders, J W de Fijter
Across the world, the proportions of senior citizens (i.e. those ≥65years) increase rapidly and are predicted to constitute over 25% of the general population by 2050. In 2012 already 48% of the population with end stage renal disease (ESRD) was aged 65years or older. Transplantation is considered the preferred treatment option for ESRD offering survival advantage over long-term dialysis in the majority of patients. Indeed, acceptable outcomes have been documented for selected patients over the age of 70years or even cases over 80years...
October 2015: Transplantation Reviews
Pamela M Kimball, Felecia A McDougan, Anne King
We used a simple point-based algorithm to identify patients who might benefit from desensitization because of their higher risk of antibody-mediated chronic rejection and graft failure. Points were assigned to known but easily determined risk factors (panel reactive antibody, flow crossmatch, delayed graft function) and calculated immediately after deceased donor kidney transplantation. Point totals were used to identify: 1) which patients would receive desensitization; and, 2) which regimen each patient would receive...
2014: Clinical Transplants
Thomas Bachelet, Charlie Martinez, Arnaud Del Bello, Lionel Couzi, Salima Kejji, Gwendaline Guidicelli, Sébastien Lepreux, Jonathan Visentin, Nicolas Congy-Jolivet, Lionel Rostaing, Jean-Luc Taupin, Nassim Kamar, Pierre Merville
BACKGROUND: It is widely accepted that HLA donor-specific antibodies (DSA) are associated with antibody-mediated rejection and graft loss. However, in many transplant programs, preformed anti-HLA-Cw and anti-HLA-DP DSA are not considered in organ allocation policies because their clinical relevance is still uncertain. METHODS: We analyzed the clinical impact of Cw/DP DSA through a retrospective study, comparing 48 patients transplanted with isolated preformed Cw/DP DSA (Cw/DP DSA group) with (i) 104 matched HLA-sensitized kidney transplant recipients with No DSA at D0 (No DSA group) and (ii) 47 kidney transplant recipients with preformed A, -B, -DR, -DQ DSA (A/B/DR/DQ DSA group)...
January 2016: Transplantation
Jeff Reeve, Philip F Halloran, Bruce Kaplan
Microarray analysis is used to tackle transplant-related problems as diverse as diagnosing rejection, predicting graft loss, and determining who can safely be removed from immunosuppression. Highly accurate predictions seem to be the norm. Unfortunately, many of these studies are flawed, either through questionable experimental design or improper validation methods. In addition, results are often presented in a misleading manner which exaggerates their true worth. In this paper, we describe the most common and serious errors and misrepresentations...
March 2015: Transplantation
Michael Abecassis, Bruce Kaplan
No abstract text is available yet for this article.
April 2015: Nature Reviews. Nephrology
Silke Roedder, Tara Sigdel, Nathan Salomonis, Sue Hsieh, Hong Dai, Oriol Bestard, Diana Metes, Adriana Zeevi, Andrea Zeevi, Albin Gritsch, Jennifer Cheeseman, Camila Macedo, Ram Peddy, Mara Medeiros, Flavio Vincenti, Nancy Asher, Oscar Salvatierra, Ron Shapiro, Allan Kirk, Elaine F Reed, Elaine Reed, Minnie M Sarwal
BACKGROUND: Development of noninvasive molecular assays to improve disease diagnosis and patient monitoring is a critical need. In renal transplantation, acute rejection (AR) increases the risk for chronic graft injury and failure. Noninvasive diagnostic assays to improve current late and nonspecific diagnosis of rejection are needed. We sought to develop a test using a simple blood gene expression assay to detect patients at high risk for AR. METHODS AND FINDINGS: We developed a novel correlation-based algorithm by step-wise analysis of gene expression data in 558 blood samples from 436 renal transplant patients collected across eight transplant centers in the US, Mexico, and Spain between 5 February 2005 and 15 December 2012 in the Assessment of Acute Rejection in Renal Transplantation (AART) study...
November 2014: PLoS Medicine
Dániel Wettstein, Dorottya Szentiványi
Overcoming antibody mediated rejection is of increasing interest in the field of transplantation immunology. The recipient's antibodies against the graft human leukocyte antigens are responsible for antibody mediated graft injury. Introduction of the solid phase immunoassay technology radically changed the monitoring practice of antibodies against human leukocyte antigens, and this has consequences both for pretransplant and posttransplant phases, though our knowledge about the clinical interpretation of the detected antibodies is limited...
November 16, 2014: Orvosi Hetilap
H G Otten, I Joosten, W A Allebes, A van der Meer, L B Hilbrands, M Baas, E Spierings, C E Hack, F van Reekum, A D van Zuilen, M C Verhaar, M L Bots, M A J Seelen, J S F Sanders, B G Hepkema, A J Lambeck, L B Bungener, C Roozendaal, M G J Tilanus, J Vanderlocht, C E Voorter, L Wieten, E van Duijnhoven, M Gelens, M Christiaans, F van Ittersum, A Nurmohamed, N M Lardy, W T Swelsen, K A M I van Donselaar-van der Pant, N C van der Weerd, I J M Ten Berge, F J Bemelman, A J Hoitsma, J W de Fijter, M G H Betjes, D L Roelen, F H J Claas
Kidney transplantation is the best treatment option for patients with end-stage renal failure. At present, approximately 800 Dutch patients are registered on the active waiting list of Eurotransplant. The waiting time in the Netherlands for a kidney from a deceased donor is on average between 3 and 4 years. During this period, patients are fully dependent on dialysis, which replaces only partly the renal function, whereas the quality of life is limited. Mortality among patients on the waiting list is high. In order to increase the number of kidney donors, several initiatives have been undertaken by the Dutch Kidney Foundation including national calls for donor registration and providing information on organ donation and kidney transplantation...
October 2014: Transplant Immunology
Maarten Naesens, Dirk R J Kuypers, Katrien De Vusser, Pieter Evenepoel, Kathleen Claes, Bert Bammens, Björn Meijers, Ben Sprangers, Jacques Pirenne, Diethard Monbaliu, Ina Jochmans, Evelyne Lerut
BACKGROUND: The relative impact on renal allograft outcome of specific histological diagnoses versus nonspecific chronic histological damage remains unclear. METHODS: All 1,197 renal allograft recipients who were transplanted at a single center between 1991 and 2001 were included. All posttransplant renal allograft indication biopsies performed in this cohort during follow-up (mean, 14.5±2.80 years after transplantation) were rescored according to the current histological criteria and associated with death-censored graft outcome...
August 27, 2014: Transplantation
L A Baxter-Lowe, M Cecka, M Kamoun, J Sinacore, M L Melcher
Multi-center kidney paired donation (KPD) is an exciting new transplant option that has not yet approached its full potential. One barrier to progress is accurate virtual crossmatching for KPD waitlists with many highly sensitized patients. Virtual crossmatch results from a large multi-center consortium, the National Kidney Registry (NKR), were analyzed to determine the effectiveness of flexible center-specific criteria for virtual crossmatching. Approximately two-thirds of the patients on the NKR waitlist are highly sensitized (>80% CPRA)...
July 2014: American Journal of Transplantation
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