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Microarray diagnosis of antibody-mediated rejection in kidney transplant biopsies: an international prospective study (INTERCOM).
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2013 Nov; Vol. 13 (11), pp. 2865-74. Date of Electronic Publication: 2013 Oct 03. - Publication Year :
- 2013
-
Abstract
- In a reference set of 403 kidney transplant biopsies, we recently developed a microarray-based test that diagnoses antibody-mediated rejection (ABMR) by assigning an ABMR score. To validate the ABMR score and assess its potential impact on practice, we performed the present prospective INTERCOM study (clinicaltrials.gov NCT01299168) in 300 new biopsies (264 patients) from six centers: Baltimore, Barcelona, Edmonton, Hannover, Manchester and Minneapolis. We assigned ABMR scores using the classifier created in the reference set and compared it to conventional assessment as documented in the pathology reports. INTERCOM documented uncertainty in conventional assessment: In 41% of biopsies where ABMR features were noted, the recorded diagnoses did not mention ABMR. The ABMR score correlated with ABMR histologic lesions and donor-specific antibodies, but not with T cell-mediated rejection lesions. The agreement between ABMR scores and conventional assessment was identical to that in the reference set (accuracy 85%). The ABMR score was more strongly associated with failure than conventional assessment, and when the ABMR score and conventional assessment disagreed, only the ABMR score was associated with early progression to failure. INTERCOM confirms the need to reduce uncertainty in the diagnosis of ABMR, and demonstrates the potential of the ABMR score to impact practice.<br /> (© Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Adolescent
Follow-Up Studies
Gene Expression Profiling
Graft Survival immunology
Humans
International Agencies
Kidney Failure, Chronic mortality
Kidney Failure, Chronic surgery
Oligonucleotide Array Sequence Analysis
Prognosis
Prospective Studies
Risk Factors
Survival Rate
Biomarkers analysis
Graft Rejection diagnosis
Graft Rejection immunology
Isoantibodies immunology
Kidney Failure, Chronic immunology
Kidney Transplantation adverse effects
Postoperative Complications
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 13
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 24119109
- Full Text :
- https://doi.org/10.1111/ajt.12465