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Researchers in one published study have identified five distinct archetypes of patients with transplanted glomerulopathy, each of which is linked to different outcomes of allograft survival..
"Most studies have consistently shown a strong badociation of transplant glomerulopathy with poor allograft results; however, in a large multicenter, well-annotated and monitored population, no previous report has discussed the potential distinct survival patterns of patients with transplanted glomerulopathy with different underlying pathogens. " Olivier Aubert, MD, PhD, from the Center for Translational Research in Paris for Organ Transplantation, and his colleagues wrote.
To characterize the heterogeneity of patients with transplant graft glomerulopathy and potentially help clinicians determine patients at high risk of allograft failure, the researchers identified 385 kidney transplant patients and presented a diagnosis of transplant glomerulopathy based on biopsies performed from January 2004. December 2014 (552 biopsies, median time between diagnosis of glomerulopathy by graft and transplant, 33.18 months). The researchers categorized patients into five distinct groups using unsupervised archetype badysis of complete pathology findings and clinical, immunological and outcome data.
After the diagnosis of graft glomerulopathy, renal allograft survival rates were 69.4%, 57.1%, 43.3% and 25.5% at 3, 5, 7 and 10 years, respectively.
The researchers found that each of the five patient archetypes had different survival profiles for allografts. When archetype 1 was used as a reference (allograft survival three years after post-transplant glomerulopathy biopsy, 92%, at age 88 at age 5), the researchers observed a gradual decrease in Survival of the allograft three and five years after transplant graft glomerulopathy biopsy in patients. archetype 3 (72% and 58%, HR = 2.16), archetype 5 (77% and 57%, HR = 2.39), archetype 2 (54% and 46%, HR = 2.92) and archetype 4 ( 36% and 22%); HR = 6.13).
Finally, the researchers examined the survival of allografts in relation to the treatment of transplanted glomerulopathy lesion and found that, for archetype 2, allograft survival at 5 years was 27.9% for patients. untreated compared to 64.6% for treated patients.
"This study responds to the current challenge of transplantation medicine, highlighted by regulatory agencies and international companies, to establish and refine diagnostic standards and to improve risk stratification in the field. renal transplantation, "wrote the researchers. "A probabilistic, data-based archetypal approach applied to a large, well-annotated multicenter cohort of renal biopsies with transplanted glomerulopathy clarifies the diagnostic and prognostic features badociated with transplanted glomerulopathy and reduces heterogeneity, thereby enhancing the characterization and stratification of the transplanted glomerulopathy. risk of transplanted glomerulopathy in the individual patient. "- by Melissa J. Webb
Disclosures: The authors do not report any relevant financial information.
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