A clinical scoring system highly predictive of long-term kidney graft survival

作者：Foucher Yohann; Daguin Pascal; Akl Ahmed; Kessler Michele; Ladriere Marc; Legendre Christophe; Kreis Henri; Rostaing Lionel; Kamar Nassim; Mourad Georges; Garrigue Valerie; Bayle Francois; de Ligny Bruno H; Buechler Mathias; Meier Carole; Daures Jean P; Soulillou Jean Paul^*; Giral Magali

来源：Kidney International, 2010, 78(12): 1288-1294.

DOI：10.1038/ki.2010.232

• graft survival
• prediction models
• surrogate end points
• transplantation

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 (Donnees Informatisees et VAlidees 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. Kidney International (2010) 78, 1288-1294; doi:10.1038/ki.2010.232; published online 22 September 2010

• 出版日期2010-12