Institut de Transplantation et de Recherche en Transplantation-Urologie-Néphrologie, CHU Nantes, IUN and INSERM U643, Nantes, France.
Kidney Int. 2010 Dec;78(12):1288-94. doi: 10.1038/ki.2010.232. Epub 2010 Sep 22.
Determining early surrogate markers of long-term graft outcome is important for optimal medical management. In order to identify such markers, we used clinical information from a cross-validated French database (Données Informatisées et VAlidées en Transplantation) of 2169 kidney transplant recipients to construct a composite score 1 year after transplantation. This Kidney Transplant Failure Score took into account a series of eight accepted pre- and post-transplant risk factors of graft loss, and was subsequently evaluated for its ability to predict graft failure at 8 years. This algorithm outperformed the traditional surrogates of serum creatinine and the estimated graft filtration rate, with an area under the receiver-operator characteristic curve of 0.78. Validation on an independent database of 317 graft recipients had the same predictive capacity. Our algorithm was also able to stratify patients into two groups according to their risk: a high-risk group of 81 patients with 25% graft failure and a low-risk group of 236 patients with an 8% failure rate. Thus, although this clinical composite score predicts long-term graft survival, it needs validation in different patient groups throughout the world.
确定长期移植物预后的早期替代标志物对于最佳的医学管理很重要。为了识别这些标志物，我们使用了来自法国经过交叉验证的数据库（Données Informatisées et VAlidées en Transplantation）的 2169 名肾移植受者的临床信息，构建了移植后 1 年的复合评分。该肾移植失败评分考虑了一系列 8 个公认的移植前和移植后移植物丢失风险因素，随后评估了其在 8 年内预测移植物失败的能力。该算法优于血清肌酐和估计的滤过率等传统替代标志物，受试者工作特征曲线下面积为 0.78。对 317 名移植物受者的独立数据库进行验证，其预测能力相同。我们的算法还能够根据风险将患者分为两组：81 名患者为高风险组，移植物失败率为 25%，236 名患者为低风险组，失败率为 8%。因此，尽管该临床复合评分可预测长期移植物存活率，但需要在世界各地的不同患者群体中进行验证。
