Highlight

  • After examining comprehensive pathology findings and clinical, immunological, and outcome data pertaining to patients with transplant glomerulopathy, investigators identified 5 groups of patients with distinct features, as well as different outcomes in terms of survival rates of transplanted kidneys.

Newswise — Washington, DC (March 14, 2019) — New research may help clinicians determine which patients with a condition that commonly arises after kidney transplantation are at high risk of transplant failure. The findings appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

A condition known as transplant glomerulopathy was first described in transplanted kidneys decades ago but its features have not been well-characterized. The condition is common, is associated with a poor prognosis, and affects the transplanted kidney’s glomeruli, the tiny ball-shaped structures composed of capillary blood vessels involved in the filtration of the blood to form urine. Transplant glomerulopathy affects 5% to 20% of kidney transplant recipients and up to 55% of those in high-risk groups, and some of its characteristics are present in several other disease processes, making its diagnosis difficult.

To provide some clarity, Olivier Aubert, MD, PhD, Alexandre Loupy, MD, PhD (Paris Translational Research Center for Organ Transplantation, in France) and their colleagues performed an analysis of comprehensive pathology findings and clinical, immunological, and outcome data to identify and characterize distinct groups of patients with transplant glomerulopathy.

By applying their data-driven machine learning approach to 385 patients diagnosed with the condition based on post-transplant biopsies, the investigators identified 5 groups of patients with distinct features, as well as different outcomes in terms of survival rates of transplanted kidneys. The team also developed a readily usable tool for clinicians that allows them to enter the clinical, histological, and immunological parameters of patients to categorize them into proper groups and predict their health outcomes (https://dyshinyapps.shinyapps.io/Archetype_Shiny/). The tool may be useful for individualizing treatments for patients based on their risk of transplant failure.

“Our research shows how we could interrogate a multilevel highly annotated dataset with patients having the same disease, in order to distinguish different profiles of patients with different profiles of transplant organ survival,” said Dr. Aubert. 

“All patients with a given disease are not equal, and machine learning approaches can help us to identify different risk profiles of allograft loss within a population of patients,” added Dr. Loupy.

Study co-authors include Olivier Aubert MD, PhD, Sarah Higgins, MD, Yassine Bouatou, MD, Daniel Yoo, PhD, Marc Raynaud, BSc, Denis Viglietti, MD, Marion Rabant, MD, Luis Hidalgo, PhD, Denis Glotz, MD, PhD, Christophe Legendre, MD, Michel Delahousse. Nikhil Shah, MD, Banu Sis, MD, Patricia Campbell, MD, Michael Mengel, MD, Xavier Jouven, MD, PhD, Jean-Paul Duong Van Huyen, MD, PhD, and Carmen Lefaucheur MD, PhD.

Disclosures: The authors reported no financial disclosures. They would like to thank La Fondation Bettencourt Schueller, Horizon 2020 and INSERM – ATIP Avenir for their financial support.

The article, entitled “Archetype Analysis Identifies Distinct Profiles in Renal Transplant Recipients with Transplant Glomerulopathy Associated with Allograft Survival,” will appear online at http://jasn.asnjournals.org/ on March 14, 2019, doi: 10.1681/ASN.2018070777.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 20,000 members representing 131 countries. For more information, please visit www.asn-online.org or contact the society at 202-640-4660.

# # #

MEDIA CONTACT
Register for reporter access to contact details
CITATIONS

doi: 10.1681/ASN.2018070777