A clinical scoring system highly predictive of long-term kidney graft survival

Determining early surrogate markers of long-term graft outcome is important for optimal medical management. In order to identify such markers, we used clinical information from a cross-validated French database (Données Informatisées et VAlidées en Transplantation) of 2169 kidney transplant recipien...

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Published in:	Kidney international Vol. 78; no. 12; pp. 1288 - 1294
Main Authors:	Foucher, Yohann, Daguin, Pascal, Akl, Ahmed, Kessler, Michèle, Ladrière, Marc, Legendre, Christophe, Kreis, Henri, Rostaing, Lionel, Kamar, Nassim, Mourad, Georges, Garrigue, Valérie, Bayle, François, de Ligny, Bruno H., Büchler, Mathias, Meier, Carole, Daurès, Jean P., Soulillou, Jean-Paul, Giral, Magali
Format:	Journal Article
Language:	English
Published:	Basingstoke Elsevier Inc 01-12-2010 Nature Publishing Group Elsevier Limited
Subjects:	Adolescent Adult Aged Aged, 80 and over Algorithms Biological and medical sciences Child Child, Preschool Female Follow-Up Studies Graft Rejection - epidemiology Graft Rejection - physiopathology graft survival Graft Survival - physiology Humans Infant Kidney Transplantation - physiology Male Medical sciences Middle Aged Nephrology. Urinary tract diseases prediction models Predictive Value of Tests Prognosis Proportional Hazards Models Reproducibility of Results Risk Factors ROC Curve surrogate end points transplantation Young Adult graft survival prediction models surrogate end points transplantation Nephrology Evaluation scale Prediction Transplantation Long term Survival Kidney Urology Treatment Urinary system Surgery Graft Models Predictive factor
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Summary:	Determining early surrogate markers of long-term graft outcome is important for optimal medical management. In order to identify such markers, we used clinical information from a cross-validated French database (Données Informatisées et VAlidées en Transplantation) of 2169 kidney transplant recipients to construct a composite score 1 year after transplantation. This Kidney Transplant Failure Score took into account a series of eight accepted pre- and post-transplant risk factors of graft loss, and was subsequently evaluated for its ability to predict graft failure at 8 years. This algorithm outperformed the traditional surrogates of serum creatinine and the estimated graft filtration rate, with an area under the receiver–operator characteristic curve of 0.78. Validation on an independent database of 317 graft recipients had the same predictive capacity. Our algorithm was also able to stratify patients into two groups according to their risk: a high-risk group of 81 patients with 25% graft failure and a low-risk group of 236 patients with an 8% failure rate. Thus, although this clinical composite score predicts long-term graft survival, it needs validation in different patient groups throughout the world.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0085-2538 1523-1755
DOI:	10.1038/ki.2010.232