[en] In kidney transplantation, day-zero biopsies are used to assess organ quality and discriminate between donor-inherited lesions and those acquired post-transplantation. However, many centers do not perform such biopsies since they are invasive, costly and may delay the transplant procedure. We aim to generate a non-invasive virtual biopsy system using routinely collected donor parameters. Using 14,032 day-zero kidney biopsies from 17 international centers, we develop a virtual biopsy system. 11 basic donor parameters are used to predict four Banff kidney lesions: arteriosclerosis, arteriolar hyalinosis, interstitial fibrosis and tubular atrophy, and the percentage of renal sclerotic glomeruli. Six machine learning models are aggregated into an ensemble model. The virtual biopsy system shows good performance in the internal and external validation sets. We confirm the generalizability of the system in various scenarios. This system could assist physicians in assessing organ quality, optimizing allograft allocation together with discriminating between donor derived and acquired lesions post-transplantation.
Disciplines :
Urology & nephrology
Author, co-author :
Yoo, Daniel; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
Divard, Gillian; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France ; Kidney Transplant Department, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
Raynaud, Marc; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
Cohen, Aaron; OneLegacy, Los Angeles, CA, USA
Mone, Tom D; OneLegacy, Los Angeles, CA, USA
Rosenthal, John Thomas; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Bentall, Andrew J ; Division of Nephrology and Hypertension, Mayo Clinic Transplant Center, Rochester, MN, USA
Stegall, Mark D; Department of Surgery, Mayo Clinic, Rochester, MN, USA
Naesens, Maarten; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
Zhang, Huanxi; Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
Wang, Changxi; Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
Gueguen, Juliette; Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, Tours, France
Kamar, Nassim; Department of Nephrology and Organ Transplantation, Paul Sabatier University, INSERM, Toulouse, France
Bouquegneau, Antoine ; Université de Liège - ULiège > Département des sciences cliniques > Néphrologie
Batal, Ibrahim ; Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
Coley, Shana M; Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
Gill, John S; Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
Oppenheimer, Federico; Kidney Transplant Department, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
De Sousa-Amorim, Erika; Kidney Transplant Department, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
Kuypers, Dirk R J; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
Durrbach, Antoine; Department of Nephrology, AP-HP Hôpital Henri Mondor, Créteil, Île de France, France
Seron, Daniel; Nephrology Department, Hospital Vall d'Hebrón, Autonomous University of Barcelona, Barcelona, Spain
Rabant, Marion; Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
Van Huyen, Jean-Paul Duong; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France ; Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
Campbell, Patricia; Faculty of Medicine & Dentistry - Laboratory Medicine & Pathology Dept, University of Alberta, Edmonton, AB, Canada
Shojai, Soroush ; Faculty of Medicine & Dentistry - Laboratory Medicine & Pathology Dept, University of Alberta, Edmonton, AB, Canada
Mengel, Michael ; Faculty of Medicine & Dentistry - Laboratory Medicine & Pathology Dept, University of Alberta, Edmonton, AB, Canada
Bestard, Oriol; Nephrology Department, Hospital Vall d'Hebrón, Autonomous University of Barcelona, Barcelona, Spain
Basic-Jukic, Nikolina; Department of nephrology, arterial hypertension, dialysis and transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
Jurić, Ivana; Department of nephrology, arterial hypertension, dialysis and transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
Boor, Peter ; Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany
Cornell, Lynn D; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
Alexander, Mariam P ; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
Toby Coates, P ; Department of Renal and Transplantation, University of Adelaide, Royal Adelaide Hospital Campus, Adelaide, SA, Australia
Legendre, Christophe; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France ; Department of Kidney Transplantation, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
Reese, Peter P; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France ; Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadephia, PA, USA
Lefaucheur, Carmen; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France ; Kidney Transplant Department, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
Aubert, Olivier; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France ; Department of Kidney Transplantation, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
Loupy, Alexandre; Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France. alexandre.loupy@inserm.fr ; Department of Kidney Transplantation, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France. alexandre.loupy@inserm.fr
We thank Sophie Ferlicot, Sandra Cockfield, Sumit Mohan, Syed A. Husain, David J. Cohen, Lloyd E. Ratner, and Maisarah Jalalonmuhali for data acquisition. French government managed by the National Research Agency (ANR) with the grant agreement ANR-17-RHUS-0010 and European Union’s Horizon 2020 research and innovation program EU-TRAIN with the grant agreement no. 754995 provided financial support. The funders of this study had no role in the study design, data collection, analysis, or interpretation of the manuscript.
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