Clinical and histological predictors of long-term kidney graft survival

Galichon, Pierre; Xu‐Dubois, Yi‐Chun; Finianos, Serge; Hertig, Alexandre; Rondeau, Éric

doi:10.1093/ndt/gfs606

Cited by 27 publications

(21 citation statements)

References 53 publications

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“…Establishment of the Organ Procurement and Transplantation Network/United Network for Organ Sharing, Eurotransplant and other databases have lead the way in identifying donor and recipient features and measures of renal function which act as indicators of long-term transplant success, including cold ischemia time, deceased versus living donor and body mass index. 1,2 Although donors and recipients are matched for clinical features shown to maximize transplant success, some immediate and early complications can occur after transplantation, including hemorrhage, thrombosis, intra-abdominal infection, and acute rejection. 1,3 Many of these are treatable with surgery or changes in immunosuppressant/induction regimes, leading to 90% to 95% of cadaveric donor organs and approximately 100% of living donor organs still functioning 1 year after transplantation.…”

Section: Kidney Transplantation In Actionmentioning

confidence: 99%

“…1,2 Although donors and recipients are matched for clinical features shown to maximize transplant success, some immediate and early complications can occur after transplantation, including hemorrhage, thrombosis, intra-abdominal infection, and acute rejection. 1,3 Many of these are treatable with surgery or changes in immunosuppressant/induction regimes, leading to 90% to 95% of cadaveric donor organs and approximately 100% of living donor organs still functioning 1 year after transplantation. Over time however kidney graft function declines, with greater than 50% of deceased donor transplanted kidneys failing within 10 years and greater than 50% of living related donor transplant kidneys failing within 17 to 18 years.…”

Section: Kidney Transplantation In Actionmentioning

confidence: 99%

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Using Genetic Variation to Predict and Extend Long-term Kidney Transplant Function

Simmonds

2015

Transplantation

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Renal transplantation has transformed the life of patients with end-stage renal disease and other chronic kidney disorders by returning endogenous kidney function and enabling patients to cease dialysis. Several clinical indicators of graft outcome and long-term function have been established. Although rising creatinine levels and graft biopsy can be used to determine graft loss, identifying early predictors of graft function will not only improve our ability to predict long-term graft outcome but importantly provide a window of opportunity to therapeutically intervene to preserve graft function before graft failure has occurred. Since understanding the importance of matching genetic variation at the HLA region between donors and recipients and translating this into clinical practise to improve transplant outcome, much focus has been placed on trying to identify additional genetic predictors of transplant outcome/function. This review will focus on how candidate gene studies have identified variants within immunosuppression, immune response, fibrotic pathways, and specific ethnic groups, which correlate with graft outcome. We will also discuss the challenges faced by candidate gene studies, such as differences in donor and recipient selection criteria and use of small data sets, which have led to many genes failing to be consistently associated with transplant outcome. This review will also look at how recent advances in our understanding of and ability to screen the genome are starting to provide new insights into the mechanisms behind long-term graft loss and with it the opportunity to target these pathways therapeutically to ultimately increase graft lifespan and the associated benefits to patients.

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Section: Kidney Transplantation In Actionmentioning

confidence: 99%

Section: Kidney Transplantation In Actionmentioning

confidence: 99%

Using Genetic Variation to Predict and Extend Long-term Kidney Transplant Function

Simmonds

2015

Transplantation

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“…These improvements in long‐term allograft outcomes have occurred despite an increased representation of features associated with graft failure over time such as increasing donor and recipient age, panel reactivity, HLA mismatches and time on dialysis (Table ) . Although improvements in longer term graft outcomes have also been reported elsewhere, particularly by other European programs and by Australia & New Zealand Dialysis & Transplant Registry (ANZDATA), these reports tend to lack the duration of follow‐up we present in this study .…”

Section: Discussionmentioning

confidence: 69%

Progressive improvement in short‐, medium‐ and long‐term graft survival in kidney transplantation patients in Ireland – a retrospective study

et al. 2019

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It is often quoted that while short-term graft survival in kidney transplantation has improved in recent years, it has not translated into a commensurate improvement in long-term graft survival. We considered whether this was true of the entire experience of the national kidney transplant program in Ireland. A retrospective analysis of the National Kidney Transplant Service (NKTS) database was undertaken to investigate patient and graft survival for all adult first deceased donor kidney transplant recipients in Ireland, 1971-2015. Three thousand two hundred and sixty recipients were included in this study. Kaplan-Meier methods were used to estimate survival at each time period post transplant for the various eras of transplantation. Uncensored graft survival has improved over the course of the program in Ireland at various time points despite risk factors for graft failure progressively increasing over successive eras. For example the graft survival at 15 years post transplant has increased from 10% in 1971-1975 to 45% by 1996-2000. Ireland has experienced a progressive improvement in long-term graft survival following kidney transplantation. Whether these trends are attributable to biological or nonbiological factors is unclear but likely involves a combination of both. Transplant International 2019; 32: 974-984

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“…Although new immunosuppressive drugs have made a major progress in improving renal graft outcome after transplantation, chronic allograft dysfunction (CAD) has remained an unsolved issue. 5,6 However, molecular pathways related to the progression of CAD act at an earlier step and their dysregulations may not be detected by the clinical methods. Indeed, CAD is recognized as a complex disease that is influenced by a range of genetics, epigenetic, and pharmacogenetic components.…”

Section: Introductionmentioning

confidence: 99%

Cell‐free microRNA‐148a is associated with renal allograft dysfunction: Implication for biomarker discovery

Nariman‐Saleh‐Fam

Bastami

Ardalan

et al. 2018

J of Cellular Biochemistry

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Background Chronic allograft dysfunction (CAD), the foremost cause of renal graft loss worldwide, is a serious challenge for most of the recipients. As the epigenetic era is emerging, epigenetic biomarkers especially microRNAs (miRNAs) may reflect the current stage of the disease and patient’s therapy response. The current study investigated the potential significance of circulating miRNA‐148a in predicting the renal graft function. Design and Methods Circulating miRNAs were isolated from 53 plasma samples of recipients with histologically validated interstitial fibrosis and tubular atrophy (IFTA, n = 26), and recipients with stable graft function (SGF, n = 27), and also healthy individuals ( n = 15). The level of miRNA‐148a was evaluated by the quantitative polymerase chain reaction (qPCR) and correlated with clinical and histological parameters. Results Significantly, miRNA‐148a decreased in IFTA compared with SGF subjects (P < 0.001). MiRNA‐148a levels indicated a significant association with serum creatinine levels ( r = 0.451, P = 0.021) and glomerular filtration rate ( r = −0.520, P = 0.006). MiRNA‐148a expression levels could discriminate IFTA cases from SGF individuals with an area under the curve of 0.89 ( P < 0.001), 97% sensitivity, and 72% specificity. A number of predicted targets that might be involved in CAD by miRNA‐148a were predicted. Conclusion Plasma cell‐free miRNA‐148a correlated with renal function and histological grades; therefore, it may be further investigated as a novel noninvasive molecular marker of the progression to IFTA in renal transplant recipients; moreover, the emerging biomarker may become a therapeutic target in the future clinic.

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Clinical and histological predictors of long-term kidney graft survival

Cited by 27 publications

References 53 publications

Using Genetic Variation to Predict and Extend Long-term Kidney Transplant Function

Using Genetic Variation to Predict and Extend Long-term Kidney Transplant Function

Progressive improvement in short‐, medium‐ and long‐term graft survival in kidney transplantation patients in Ireland – a retrospective study

Cell‐free microRNA‐148a is associated with renal allograft dysfunction: Implication for biomarker discovery

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