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Development and Validation of a Multidimensional Score to Predict Long-term Kidney Transplant Outcomes

Completed
Conditions
Kidney Transplantation
Registration Number
NCT03474003
Lead Sponsor
Paris Translational Research Center for Organ Transplantation
Brief Summary

To further develop personalized medicine in kidney transplantation and improve transplant patient outcomes, attention has been given to define early surrogate endpoints that might aid therapeutic interventions, clinical trials and clinical decision-making.

Despite a clear pressing need, no population-scale prognostication system exists that will combine traditional factors and biomarker candidates to represent the complete spectrum of risk predicting parameters. To adequately predict transplant patients' individual risks of allograft loss, this would require a complex integration of data, including: donor data, recipient characteristics, transplant characteristics, allograft precision phenotypes, ethnicity, immunosuppressive regimen monitoring, allograft infections, acute kidney injuries, and recipient immune profiles.

This project aims:

1. To develop a generalizable, transportable, mechanistically and data driven composite surrogate end point in kidney transplantation;

2. To validate several risk scores to predict kidney allograft survival and response to treatment of individual patients;

Eventually, it will provide an easily accessible tool to calculate individual patients' risk profiles after kidney transplantation, by using datasets from prospective cohorts and post hoc analysis of randomized control trial datasets.

Detailed Description

Background The field of kidney transplantation currently lacks robust models to predict long-term allograft failure, which represents a major unmet need in clinical care and clinical trials. This study aims to generate and validate an accessible scoring system that predicts individual patients' risk of long-term kidney allograft failure.

Main Outcome(s) and Measure(s)

A score based on classical statistical approaches to model determinants of allograft and patient survival (Cox model, multinomial regression). These models will be further completed with statistical approaches derived from artificial intelligence and machine learning.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
7557
Inclusion Criteria
  • Kidney recipient transplanted after 2002
  • Kidney recipient over 18 years of age
Exclusion Criteria
  • Combined transplantation

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Allograft survival probabilityAllograft survival probability at 7 year post transplantation

Allograft survival probability, calculated from a composite score (based on clinical, histological, immunological, and functional variables) assessed at the time of biopsy.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (10)

Department of Surgery, Johns Hopkins University School of Medicine

🇺🇸

Baltimore, Maryland, United States

Department of Nephrology and Renal Transplantation, University Hospitals Leuven

🇧🇪

Leuven, Belgium

Centre Hospitalier Universitaire de Nantes

🇫🇷

Nantes, France

Virginia Commonwealth University School of Medicine

🇺🇸

Richmond, Virginia, United States

William J. von Liebig Center for Transplantation and Clinical Regeneration

🇺🇸

Rochester, Minnesota, United States

Department of Transplantation, Nephrology and Clinical Immunology, Hospices Civils de Lyon

🇫🇷

Lyon, France

Kidney Transplant Department, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France ;

🇫🇷

Paris, France

Kidney Transplant Department, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France;

🇫🇷

Paris, France

Department of Nephrology and Organ Transplantation, CHU Rangueil

🇫🇷

Toulouse, France

Department of Transplantation, Nephrology and Clinical Immunology, Hôpital Foch, Suresnes, France

🇫🇷

Suresnes, France

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