Abnormalities in Protocol Graft Kidney Biopsy 6 Months Posttransplantation in a Tertiary Care Center Hospital of Nepal

Shrestha, Mitesh; Singh, Dibya; Sigdel, Mahesh Raj; Kafle, Mukunda Prasad

doi:10.1016/j.transproceed.2018.03.042

Cited by 3 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of SCR in our study was determined to be 14.6%. When excluding BCR, the rejection rate was found to be 5.6%, which is comparable to the rejection rates (7.5–10.7%) reported in other studies involving protocol biopsies conducted within 1–6 months post-transplantation 16 – 18 . However, our observed rejection rate was lower than the previously reported rate of 17% for the 1–2 week period 19 .…”

Section: Discussionsupporting

confidence: 78%

Prediction of very early subclinical rejection with machine learning in kidney transplantation

Jo,

Park,

Lee

2023

Sci Rep

View full text Add to dashboard Cite

Protocol biopsy is a reliable method for assessing allografts status after kidney transplantation (KT). However, due to the risk of complications, it is necessary to establish indications and selectively perform protocol biopsies by classifying the high-risk group for early subclinical rejection (SCR). Therefore, the purpose of this study is to analyze the incidence and risk factors of early SCR (within 2 weeks) and develop a prediction model using machine learning. Patients who underwent KT at Samsung Medical Center from January 2005 to December 2020 were investigated. The incidence of SCR was investigated and risk factors were analyzed. For the development of prediction model, machine learning methods (random forest, elastic net, extreme gradient boosting [XGB]) and logistic regression were used and the performance between the models was evaluated. The cohorts of 987 patients were reviewed and analyzed. The incidence of SCR was 14.6%. Borderline cellular rejection (BCR) was the most common type of rejection, accounting for 61.8% of cases. In the analysis of risk factors, recipient age (OR 0.98, p = 0.03), donor BMI (OR 1.07, p = 0.02), ABO incompatibility (OR 0.15, p < 0.001), HLA II mismatch (two [OR 6.44, p < 0.001]), and ATG induction (OR 0.41, p < 0.001) were associated with SCR in the multivariate analysis. The logistic regression prediction model (average AUC = 0.717) and the elastic net model (average AUC = 0.712) demonstrated good performance. HLA II mismatch and induction type were consistently identified as important variables in all models. The odds ratio analysis of the logistic prediction model revealed that HLA II mismatch (OR 6.77) was a risk factor for SCR, while ATG induction (OR 0.37) was a favorable factor. Early SCR was associated with HLA II mismatches and induction agent and prediction model using machine learning demonstrates the potential to predict SCR.

show abstract

Section: Discussionsupporting

confidence: 78%

Prediction of very early subclinical rejection with machine learning in kidney transplantation

Jo,

Park,

Lee

2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…After the removal of duplicates, 5004 unique records were identified, of which 4814 records were excluded after the screening of titles and abstracts. Of the 190 remaining studies, 72 studies (40 082 biopsies) 2,3,9,14,25-92 were included in the systematic review and meta-analysis after full-text review (Figure 1) including 4 single-center randomized controlled trials, 3 multicenter cohort studies (1 mixed retrospective-prospective and 2 retrospective), and 65 single-center cohort studies (10 prospective, 1 mixed retrospective-prospective, 46 retrospective, and 8 unreported). Details of the included studies are presented in Table S1, SDC, http://links.lww.com/TP/C332.…”

Section: Resultsmentioning

confidence: 99%

Complications of Percutaneous Kidney Allograft Biopsy: Systematic Review and Meta-analysis

Lim

Tan

et al. 2022

Transplantation

View full text Add to dashboard Cite

Background. Kidney biopsy is important to guide the management of allograft dysfunction but has a risk of complications. This review aimed to determine the incidence and risk factors of complications after kidney allograft biopsy. Methods. This is a systematic review and meta-analysis of randomized controlled trials, cohort studies, or case-control studies indexed on PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry, and ClinicalTrials.gov, limited to the English language, from January 2000 to December 2020, including adult and pediatric kidney allograft biopsies. Primary outcomes were gross hematuria, bleeding requiring transfusion, and major complications (requiring interventions such as blood transfusion or surgical or radiological interventions). Results. The review included 72 studies (40 082 biopsies). The quality of included studies was suboptimal. Pooled rates of gross hematuria, bleeding requiring transfusion, and major complications were 3.18% [95% confidence interval (95% CI), 2.31-4.19], 0.31% (95% CI, 0.15-0.52) and 0.89% (95% CI, 0.61-1.22), respectively. Gross hematuria rates were lower in high-income compared with middle-income countries (2.59% versus 6.44%, P < 0.01) and biopsies performed by radiology as compared with nephrology departments (1.25% versus 3.71%, P < 0.01). Blood transfusion rates were lower in pediatrics than adults (0.0% versus 0.65%, P < 0.01). Major complications were lower in biopsies performed by specialists as compared with trainees (0.02% versus 3.64%, P < 0.01). Graft loss and mortality were extremely rare. Limitations included missing data, few randomized controlled trials, and possible publication bias. Conclusions. The risk of complications after kidney allograft biopsy was low. Given the low quality of included studies, risk factors for complications should be further examined in future studies.

show abstract

The Value of Protocol Biopsy in Kidney Transplantation on Monitoring Transplant Outcomes: A Systematic Review and Meta-Analysis

Garcia-Lopez,

Calderon-Zapata,

Gomez-Montero

et al. 2024

Transplantation Proceedings

View full text Add to dashboard Cite

Abnormalities in Protocol Graft Kidney Biopsy 6 Months Posttransplantation in a Tertiary Care Center Hospital of Nepal

Cited by 3 publications

References 16 publications

Prediction of very early subclinical rejection with machine learning in kidney transplantation

Prediction of very early subclinical rejection with machine learning in kidney transplantation

Complications of Percutaneous Kidney Allograft Biopsy: Systematic Review and Meta-analysis

The Value of Protocol Biopsy in Kidney Transplantation on Monitoring Transplant Outcomes: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About