A5047586911- Renal Transplantation Outcomes and Treatments
- Organ Transplantation Techniques and Outcomes
- Transplantation: Methods and Outcomes
- Renal and Vascular Pathologies
- Renal Diseases and Glomerulopathies
- Cytomegalovirus and herpesvirus research
- Organ Donation and Transplantation
- Polyomavirus and related diseases
- Neurological Complications and Syndromes
- Atrial Fibrillation Management and Outcomes
- Pregnancy and Medication Impact
- Energy Harvesting in Wireless Networks
- Chronic Kidney Disease and Diabetes
- Advanced Causal Inference Techniques
- Systemic Lupus Erythematosus Research
- Liver Disease and Transplantation
- Statistical Methods and Inference
- Fetal and Pediatric Neurological Disorders
- Biomedical Research and Pathophysiology
- Vascular anomalies and interventions
- Parvovirus B19 Infection Studies
- Genetic and Kidney Cyst Diseases
- Heart Failure Treatment and Management
- Blood Pressure and Hypertension Studies
- Coagulation, Bradykinin, Polyphosphates, and Angioedema
KU Leuven
2018-2025
Statistics Belgium
2018-2025
New York University
2023
RELX Group (United States)
2023
Universitair Ziekenhuis Leuven
2019
Significance Statement HLA matching for three loci (HLA-A, HLA-B, and HLA-DR) at a low-resolution antigen level has been integral to algorithms allocating donor kidneys transplant since the 1970s. The authors used high-resolution genotyping of 11 analysis mismatches eplets—small patches surface-exposed amino acids molecule—to evaluate effect eplet on de novo formation donor-specific antibodies (DSAs) kidney outcome. They found that in HLA-DQ locus are most important DSA formation, rejection,...
In this cohort study (n = 935 transplantations), we investigated the phenotype and risk of graft failure in patients with histological criteria for antibody-mediated rejection (ABMR) absence circulating donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA), compared to definite ABMR HLA-DSA-positivity. The picture did not differ between HLA-DSA-positive 85) HLA-DSA-negative 123) cases histology, apart from increased complement split product 4d (C4d) deposition peritubular...
In this cohort study (N = 924), we investigated the evolution and clinical significance of pretransplant donor-specific HLA antibodies (preDSA), detected in single-antigen beads assay but complement-dependent cytotoxicity crossmatch-negative. Donor specificity preDSA 107) was determined by high-resolution genotyping donor-recipient pairs. We found that 52% patients with preDSA, spontaneously resolved within first 3 months posttransplant. PreDSA persisted posttransplant had higher median...
The need for extended second field high-resolution (2F-HR) HLA genotyping in kidney transplantation is debated. In a cohort of 1000 transplants, we evaluated the impact different levels on assignment donor-specific anti-HLA antibodies (DSA) and investigated whether inference 2F-HR genotypes from low-resolution (LR) could be used to correctly assign DSA. Based LR genotypes, 224 pretransplant DSAs were present 140 patients absent 860 (DSAneg group). With genotyping, confirmed 173 DSA (77.2%)...
Significance Statement Microvascular inflammation (MVI) of the kidney transplant is an important determinant allograft outcome. Although MVI considered a cardinal manifestation antibody-mediated rejection, it often encountered in absence circulating donor-specific antibodies, which raises uncertainty about underlying cause. The authors used genotyping killer cell Ig-like receptors recipients and high-resolution HLA to assess presence missing self, nonhumoral natural stimulus, large cohort...
In survival analysis, competing events preclude the occurrence of event interest. The censoring is common in medical studies but leads to biased cumulative incidence estimators. Competing risks methods, such as non-parametric Aalen-Johansen method or semi-parametric Fine and Gray model, alleviate this bias should be preferred above Kaplan-Meier Cox respectively. As an illustrative example, a large European cohort, we report on differences estimates graft failure after kidney transplantation,...
Rationale & ObjectivePrior studies have demonstrated the diagnostic potential of urinary chemokines CXCL9 and CXCL10 for kidney transplant rejection. However, their benefit in addition to clinical information has not been demonstrated. We evaluated performance detecting acute rejection when integrated with information.Study DesignSingle-center prospective cohort study.Setting& Participants: analyzed 1559 biopsy-paired samples from 622 transplants performed between April 2013 July 2019 at a...
BackgroundAntibody-mediated rejection, a leading cause of renal allograft graft failure, is diagnosed by histological assessment invasive biopsies. Accurate non-invasive biomarkers are not available.MethodsIn the multicentre, prospective BIOMARGIN study, blood samples were prospectively collected at time biopsies between June 2011 and August 2016 analyzed in three phases. The discovery derivation phases study (N = 117 N 183 respectively) followed case-control design included whole genome...
Background. Although graft loss is a primary endpoint in many studies kidney transplantation and broad spectrum of risk factors has been identified, the eventual causes failure individual cases remain ill studied. Methods. We performed single-center cohort study 1000 renal allograft recipients, transplanted between March 2004 February 2013. Results. In total, 365 losses (36.5%) were which 211 (57.8%) due to recipient death with functioning 154 (42.2%) defined as return dialysis or...
Abstract Background Studies that compare kidney outcomes across patients with different forms of focal segmental glomerulosclerosis (FSGS) are lacking. Methods This retrospective study compared annual estimated glomerular filtration rate (eGFR) slope and failure (KF) (eGFR < 15 mL/min/1.73 m2 or initiation replacement therapy) biopsy-proven primary, maladaptive, genetic undetermined FSGS. Patients were included from two Belgian tertiary referral hospitals, 2010 until 2022....
The histology of antibody-mediated rejection after kidney transplantation is observed frequently in the absence detectable donor-specific anti-HLA antibodies. Although there an active interest role non-HLA antibodies this phenotype, it remains unknown whether HLA mismatches play antibody-independent phenotype microcirculation inflammation.To study this, we used tools HLAMatchmaker, three-dimensional electrostatic mismatch score, solvent accessible amino acid mismatches, and mismatched donor...
Despite the critical role of cytokines in allograft rejection, relation peripheral blood cytokine profiles to clinical kidney transplant rejection has not been fully elucidated. We assessed 28 through multiplex assay 293 samples from recipients at time graft dysfunction. Unsupervised hierarchical clustering identified a subset patients with increased pro-inflammatory levels. This patient was hallmarked by high prevalence (75%) donor-specific anti-human leukocyte antigen antibodies (HLA-DSA)...
Transplant glomerulopathy is established as a hallmark of chronic antibody-mediated rejection in kidney transplant patients with donor-specific HLA antibodies (HLA-DSA). The clinical importance the absence HLA-DSA not well established. To help define this, 954 (encompassing 3744 biopsies) who underwent transplantation 2004-2013 were studied retrospective high-resolution genotyping both donors and recipients. risk factors, histopathological appearance prognosis cases compared to those...
OBJECTIVE The kinetics and risk factors of diabetic nephropathy after kidney transplantation remain unclear. This study investigated the posttransplant occurrence contribution glycemic control. RESEARCH DESIGN AND METHODS We performed a single-center prospective cohort 953 renal allograft recipients 3,458 protocol-specified biopsy specimens up to 5 years transplantation. effects pretransplant diabetes control (glycated hemoglobin levels) on histology were studied. RESULTS Before...
Abstract Background When the blood supply ceases in a deceased organ donor, ischaemic injury starts. Kidneys are cooled to reduce cellular metabolism and minimize injury. This cooling is slow kidneys lukewarm during nephrectomy. Smaller single-centre studies have shown that prolonged donor nephrectomy time decreases early kidney transplant function, but effect on long-term outcome has never been investigated large multicentre cohort studies. Methods The relationship between death-censored...
Key Points Prediction models are becoming increasingly relevant in precision medicine. These should be highly performant and not negatively affected by competing risk events. We thus aimed to carefully assess the effect of risks allograft failure prediction. Background Prognostic clinical trials as potential surrogate end points for patient management decision support tools. However, on model performance remains poorly investigated. noncompeting context kidney transplantation, where death...