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

NCT ID: NCT03474003

Last Updated: 2020-05-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

7557 participants

Study Classification

OBSERVATIONAL

Study Start Date

2002-01-31

Study Completion Date

2020-04-29

Brief Summary

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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

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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.

Conditions

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Kidney Transplantation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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No intervention

Kidney recipients aged over 18 and of all sexes recruited from 2002 in European and North American centers, who have eGFR follow-up and data from protocol and for cause biopsies available for allograft survival assessment; RCT conducted over the past 20 years with available data on protocol biopsy within the first year and follow up clinical, biological and histological data.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Kidney recipient transplanted after 2002
* Kidney recipient over 18 years of age

Exclusion Criteria

* Combined transplantation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Paris Translational Research Center for Organ Transplantation

OTHER

Sponsor Role lead

Responsible Party

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Professor Alexandre Loupy

Professor Alexandre Loupy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alexandre Loupy, PhD

Role: PRINCIPAL_INVESTIGATOR

Paris Translational Research Center for Organ Transplantation

Carmen Lefaucheur, PhD

Role: PRINCIPAL_INVESTIGATOR

Paris Translational Research Center for Organ Transplantation

Locations

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Department of Surgery, Johns Hopkins University School of Medicine

Baltimore, Maryland, United States

Site Status

William J. von Liebig Center for Transplantation and Clinical Regeneration

Rochester, Minnesota, United States

Site Status

Virginia Commonwealth University School of Medicine

Richmond, Virginia, United States

Site Status

Department of Nephrology and Renal Transplantation, University Hospitals Leuven

Leuven, , Belgium

Site Status

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

Lyon, , France

Site Status

Centre Hospitalier Universitaire de Nantes

Nantes, , France

Site Status

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

Paris, , France

Site Status

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

Paris, , France

Site Status

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

Suresnes, , France

Site Status

Department of Nephrology and Organ Transplantation, CHU Rangueil

Toulouse, , France

Site Status

Countries

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United States Belgium France

References

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Truchot A, Raynaud M, Helantera I, Aubert O, Kamar N, Divard G, Astor B, Legendre C, Hertig A, Buchler M, Crespo M, Akalin E, Pujol GS, Ribeiro de Castro MC, Matas AJ, Ulloa C, Jordan SC, Huang E, Juric I, Basic-Jukic N, Coemans M, Naesens M, Friedewald JJ, Silva HT Jr, Lefaucheur C, Segev DL, Collins GS, Loupy A. Competing and Noncompeting Risk Models for Predicting Kidney Allograft Failure. J Am Soc Nephrol. 2025 Apr 1;36(4):688-701. doi: 10.1681/ASN.0000000517. Epub 2024 Oct 16.

Reference Type DERIVED
PMID: 40168162 (View on PubMed)

Aubert O, Divard G, Pascual J, Oppenheimer F, Sommerer C, Citterio F, Tedesco H, Chadban S, Henry M, Vincenti F, Srinivas T, Watarai Y, Legendre C, Bernhardt P, Loupy A. Application of the iBox prognostication system as a surrogate endpoint in the TRANSFORM randomised controlled trial: proof-of-concept study. BMJ Open. 2021 Oct 7;11(10):e052138. doi: 10.1136/bmjopen-2021-052138.

Reference Type DERIVED
PMID: 34620664 (View on PubMed)

Loupy A, Aubert O, Orandi BJ, Naesens M, Bouatou Y, Raynaud M, Divard G, Jackson AM, Viglietti D, Giral M, Kamar N, Thaunat O, Morelon E, Delahousse M, Kuypers D, Hertig A, Rondeau E, Bailly E, Eskandary F, Bohmig G, Gupta G, Glotz D, Legendre C, Montgomery RA, Stegall MD, Empana JP, Jouven X, Segev DL, Lefaucheur C. Prediction system for risk of allograft loss in patients receiving kidney transplants: international derivation and validation study. BMJ. 2019 Sep 17;366:l4923. doi: 10.1136/bmj.l4923.

Reference Type DERIVED
PMID: 31530561 (View on PubMed)

Other Identifiers

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IBOX001

Identifier Type: -

Identifier Source: org_study_id

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