当前位置:
X-MOL 学术
›
Clin. J. Am. Soc. Nephrol.
›
论文详情
Our official English website, www.x-mol.net, welcomes your
feedback! (Note: you will need to create a separate account there.)
Systematic Biopsy-Based Transcriptomics and Diagnosis of Antibody-Mediated Kidney Transplant Rejection in Clinical Practice
Clinical Journal of the American Society of Nephrology ( IF 8.5 ) Pub Date : 2024-07-16 , DOI: 10.2215/cjn.0000000000000490 Jeanne Dandonneau 1 , Arnaud François 2 , Dominique Bertrand 3 , Sophie Candon 4 , Tristan de Nattes 5
Clinical Journal of the American Society of Nephrology ( IF 8.5 ) Pub Date : 2024-07-16 , DOI: 10.2215/cjn.0000000000000490 Jeanne Dandonneau 1 , Arnaud François 2 , Dominique Bertrand 3 , Sophie Candon 4 , Tristan de Nattes 5
Affiliation
ted rejection diagnosis in clinical practice. Background To diagnose kidney transplant antibody-mediated rejection (AMR), biopsy-based transcriptomics can substitute for some histological criteria according to the Banff classification. However, clinical accessibility of these assays is still limited. Here, we aimed to evaluate the impact of integrating a routine-compatible molecular assay for the diagnosis of AMR in clinical practice. Methods All biopsies performed in our center between 2013 and 2017 were retrospectively included. These biopsies were classified into three groups: AMR biopsies which displayed the full Banff criteria of AMR independently of biopsy-based transcriptomics; undetermined for AMR biopsies which did not meet AMR histological criteria, but would have been considered as AMR if biopsy-based transcriptomics had been positive; and control biopsies which showed no features of rejection. Results Within the inclusion period, 342 biopsies had a complete Banff scoring. Thirty-six of the biopsies already met AMR criteria, and 43 of 306 (14%) were considered as undetermined for AMR. Among these biopsies, 24 of 43 (56%) had a molecular signature of AMR, reclassifying them into the AMR category. Five-year death-censored survival of these biopsies was unfavorable and statistically equivalent to that of the AMR category (P = 0.22), with 15 of 24 (63%) graft loss. Conclusions A significant proportion of biopsies could benefit from a biopsy-based transcriptomics for AMR diagnosis according to the Banff classification. Using a routine-compatible molecular tool, more than the half of these biopsies were reclassified as AMR and associated with poor allograft survival....
中文翻译:
临床实践中基于系统活检的转录组学和抗体介导的肾移植排斥反应的诊断
临床实践中的排斥反应诊断。背景 为了诊断肾移植抗体介导的排斥反应 (AMR),基于活检的转录组学可以替代根据班夫分类的一些组织学标准。然而,这些测定的临床可及性仍然有限。在这里,我们的目的是评估在临床实践中整合常规兼容分子检测对 AMR 诊断的影响。方法回顾性纳入2013年至2017年在我中心进行的所有活检。这些活检分为三组: AMR 活检,显示 AMR 的完整班夫标准,独立于基于活检的转录组学;对于不符合 AMR 组织学标准的 AMR 活检,尚未确定,但如果基于活检的转录组学呈阳性,则将被视为 AMR;和对照活检未显示排斥特征。结果 在纳入期内,342 个活检组织具有完整的班夫评分。其中 36 份活检已符合 AMR 标准,306 份中有 43 份 (14%) 被认为未确定 AMR。在这些活检中,43 个活检中的 24 个(56%)具有 AMR 分子特征,将其重新分类为 AMR 类别。这些活检的五年死亡审查生存率不利,并且在统计上与 AMR 类别相当(P = 0.22),24 例中有 15 例(63%)移植物丢失。结论 根据班夫分类,很大一部分活检可以受益于基于活检的转录组学诊断 AMR。使用常规兼容的分子工具,超过一半的活检被重新分类为 AMR,并与同种异体移植物存活率较差相关......
更新日期:2024-07-16
中文翻译:
临床实践中基于系统活检的转录组学和抗体介导的肾移植排斥反应的诊断
临床实践中的排斥反应诊断。背景 为了诊断肾移植抗体介导的排斥反应 (AMR),基于活检的转录组学可以替代根据班夫分类的一些组织学标准。然而,这些测定的临床可及性仍然有限。在这里,我们的目的是评估在临床实践中整合常规兼容分子检测对 AMR 诊断的影响。方法回顾性纳入2013年至2017年在我中心进行的所有活检。这些活检分为三组: AMR 活检,显示 AMR 的完整班夫标准,独立于基于活检的转录组学;对于不符合 AMR 组织学标准的 AMR 活检,尚未确定,但如果基于活检的转录组学呈阳性,则将被视为 AMR;和对照活检未显示排斥特征。结果 在纳入期内,342 个活检组织具有完整的班夫评分。其中 36 份活检已符合 AMR 标准,306 份中有 43 份 (14%) 被认为未确定 AMR。在这些活检中,43 个活检中的 24 个(56%)具有 AMR 分子特征,将其重新分类为 AMR 类别。这些活检的五年死亡审查生存率不利,并且在统计上与 AMR 类别相当(P = 0.22),24 例中有 15 例(63%)移植物丢失。结论 根据班夫分类,很大一部分活检可以受益于基于活检的转录组学诊断 AMR。使用常规兼容的分子工具,超过一半的活检被重新分类为 AMR,并与同种异体移植物存活率较差相关......