دورية أكاديمية
Progressive decline of function in renal allografts with normal 1-year biopsies: Gene expression studies fail to identify a classifier
العنوان: | Progressive decline of function in renal allografts with normal 1-year biopsies: Gene expression studies fail to identify a classifier |
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المؤلفون: | Park, Walter D, Kim, Dean, Mai, Martin, Reddy, Kunam S, Gonwa, Thomas, Ryan, Margaret S, Herrera Hernandez, Loren P, Smith, Maxwell L, Geiger, Xochiquetzal J, Turkevi-Nagy, Sandor, Cornell, Lynn D, Smith, Byron H, Kremers, Walter K, Stegall, Mark D |
المصدر: | Surgery Articles |
بيانات النشر: | Henry Ford Health Scholarly Commons |
سنة النشر: | 2021 |
المجموعة: | Henry Ford Health System Scholarly Commons |
مصطلحات موضوعية: | Transplant and Abdominal Surgery |
الوصف: | Histologic findings on 1-year biopsies such as inflammation with fibrosis and transplant glomerulopathy predict renal allograft loss by 5 years. However, almost half of the patients with graft loss have a 1-year biopsy that is either normal or has only interstitial fibrosis. The goal of this study was to determine if there was a gene expression profile in these relatively normal 1-year biopsies that predicted subsequent decline in renal function. Using transcriptome microarrays we measured intragraft mRNA levels in a retrospective Discovery cohort (170 patients with a normal/minimal fibrosis 1-year biopsy, 54 with progressive decline in function/graft loss and 116 with stable function) and developed a nested 10-fold cross-validated gene classifier that predicted progressive decline in renal function (positive predictive value = 38 ± 34%%; negative predictive value = 73 ± 30%, c-statistic = .59). In a prospective, multicenter Validation cohort (270 patients with Normal/Interstitial Fibrosis [IF]), the classifier had a 20% positive predictive value, 85% negative predictive value and .58 c-statistic. Importantly, the majority of patients with graft loss in the prospective study had 1-year biopsies scored as Normal or IF. We conclude predicting graft loss in many renal allograft recipients (i.e., those with a relatively normal 1-year biopsy and eGFR > 40) remains difficult. |
نوع الوثيقة: | text |
وصف الملف: | application/pdf |
اللغة: | unknown |
العلاقة: | https://scholarlycommons.henryford.com/surgery_articles/536Test; http://sfxhosted.exlibrisgroup.com/hfhs?sid=Entrez:PubMed&id=pmid:34717009Test |
الإتاحة: | https://scholarlycommons.henryford.com/surgery_articles/536Test http://sfxhosted.exlibrisgroup.com/hfhs?sid=Entrez:PubMed&id=pmid:34717009Test |
رقم الانضمام: | edsbas.D140FB88 |
قاعدة البيانات: | BASE |
الوصف غير متاح. |