Incidence, Risk Factors, and Effect on Allograft Survival of Glomerulonephritis Post-transplantation in a United Kingdom Population: Cohort Study.
end-stage renal disease
graft failure
kidney transplantation
machine learning
recurrent glomerulonephritis
Journal
Frontiers in nephrology
ISSN: 2813-0626
Titre abrégé: Front Nephrol
Pays: Switzerland
ID NLM: 9918469487906676
Informations de publication
Date de publication:
2022
2022
Historique:
received:
19
04
2022
accepted:
17
06
2022
medline:
14
7
2022
pubmed:
14
7
2022
entrez:
7
9
2023
Statut:
epublish
Résumé
Post-transplant glomerulonephritis (PTGN) has been associated with inferior long-term allograft survival, and its incidence varies widely in the literature. This is a cohort study of 7,623 patients transplanted between 2005 and 2016 at four major transplant UK centres. The diagnosis of glomerulonephritis (GN) in the allograft was extracted from histology reports aided by the use of text-mining software. The incidence of the four most common GN post-transplantation was calculated, and the risk factors for disease and allograft outcomes were analyzed. In total, 214 patients (2.8%) presented with PTGN. IgA nephropathy (IgAN), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), and membranoproliferative/mesangiocapillary GN (MPGN/MCGN) were the four most common forms of post-transplant GN. Living donation, HLA DR match, mixed race, and other ethnic minority groups were associated with an increased risk of developing a PTGN. Patients with PTGN showed a similar allograft survival to those without in the first 8 years of post-transplantation, but the results suggest that they do less well after that timepoint. IgAN was associated with the best allograft survival and FSGS with the worst allograft survival. PTGN has an important impact on long-term allograft survival. Significant challenges can be encountered when attempting to analyze large-scale data involving unstructured or complex data points, and the use of computational analysis can assist.
Sections du résumé
Background
UNASSIGNED
Post-transplant glomerulonephritis (PTGN) has been associated with inferior long-term allograft survival, and its incidence varies widely in the literature.
Methods
UNASSIGNED
This is a cohort study of 7,623 patients transplanted between 2005 and 2016 at four major transplant UK centres. The diagnosis of glomerulonephritis (GN) in the allograft was extracted from histology reports aided by the use of text-mining software. The incidence of the four most common GN post-transplantation was calculated, and the risk factors for disease and allograft outcomes were analyzed.
Results
UNASSIGNED
In total, 214 patients (2.8%) presented with PTGN. IgA nephropathy (IgAN), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), and membranoproliferative/mesangiocapillary GN (MPGN/MCGN) were the four most common forms of post-transplant GN. Living donation, HLA DR match, mixed race, and other ethnic minority groups were associated with an increased risk of developing a PTGN. Patients with PTGN showed a similar allograft survival to those without in the first 8 years of post-transplantation, but the results suggest that they do less well after that timepoint. IgAN was associated with the best allograft survival and FSGS with the worst allograft survival.
Conclusions
UNASSIGNED
PTGN has an important impact on long-term allograft survival. Significant challenges can be encountered when attempting to analyze large-scale data involving unstructured or complex data points, and the use of computational analysis can assist.
Identifiants
pubmed: 37675026
doi: 10.3389/fneph.2022.923813
pmc: PMC10479671
doi:
Types de publication
Journal Article
Langues
eng
Pagination
923813Informations de copyright
Copyright © 2022 Aguiar, Bourmpaki, Bunce, Coker, Delaney, de Jongh, Oliveira, Weir, Higgins, Spiridou, Hasan, Smith, Mulla, Glampson, Mercuri, Montero, Hernandez-Fuentes, Roufosse, Simmonds, Clatworthy, McLean, Ploeg, Davies, Várnai, Woods, Lord, Pruthi, Breen and Chowdhury.
Déclaration de conflit d'intérêts
MH-F is currently an employee of UCB Celltech, a pharmaceutical company. Her involvement in the conduct of this research was solely in her capacity as academic at King’s College London. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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