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11 décembre 2019Poor long-term outcome in second kidney transplantation : a delayed event
Auteurs
- Trébern-Launay Katy - INSERM U1064
- Foucher Yohann - Maître de Conférences en Biostatistique - HDR - UFR de médecine - Université de Nantes
- Giral Magali - PU-PH - CHU de Nantes
- Legendre C.
- Kreiss H
- Kessler M
- Ladrière M
- Kamar N
- Rostaing L
- Garrigue V
- Mourad G
- Morelon E
- Soulillou Jean-Paul
- Dantal J
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Résumé
BACKGROUND: Old studies reported a worse outcome for second transplant recipient (STR) than for first transplant recipient (FTR) mainly due to non-comparable populations with numbers confounding factors. More recent analysis, based on improved methodology by using multivariate regressions, challenged this generally accepted idea: the poor prognosis for STR is still under debate. METHODOLOGY: To assess the long-term patient-and-graft survival of STR compared to FTR, we performed an observational study based on the French DIVAT prospective cohort between 1996 and 2010 (N = 3103 including 641 STR). All patients were treated with a CNI, an mTOR inhibitor or belatacept in addition to steroids and mycophenolate mofetil for maintenance therapy. Patient-and-graft survival and acute rejection episode (ARE) were analyzed using Cox models adjusted for all potential confounding factors such as pre-transplant anti-HLA immunization. RESULTS: We showed that STR have a higher risk of graft failure than FTR (HR = 2.18, p = 0.0013) but that this excess risk was observed after few years of transplantation. There was no significant difference between STR and FTR in the occurrence of either overall ARE (HR = 1.01, p = 0.9675) or steroid-resistant ARE (HR = 1.27, p = 0.4087). CONCLUSIONS: The risk of graft failure following second transplantation remained consistently higher than that observed in first transplantation after adjusting for confounding factors. The rarely performed time-dependent statistical modeling may explain the heterogeneous conclusions of the literature concerning second transplantation outcomes. In clinical practice, physicians should not consider STR and FTR equally.
Abstract
BACKGROUND: Old studies reported a worse outcome for second transplant recipient (STR) than for first transplant recipient (FTR) mainly due to non-comparable populations with numbers confounding factors. More recent analysis, based on improved methodology by using multivariate regressions, challenged this generally accepted idea: the poor prognosis for STR is still under debate. METHODOLOGY: To assess the long-term patient-and-graft survival of STR compared to FTR, we performed an observational study based on the French DIVAT prospective cohort between 1996 and 2010 (N = 3103 including 641 STR). All patients were treated with a CNI, an mTOR inhibitor or belatacept in addition to steroids and mycophenolate mofetil for maintenance therapy. Patient-and-graft survival and acute rejection episode (ARE) were analyzed using Cox models adjusted for all potential confounding factors such as pre-transplant anti-HLA immunization. RESULTS: We showed that STR have a higher risk of graft failure than FTR (HR = 2.18, p = 0.0013) but that this excess risk was observed after few years of transplantation. There was no significant difference between STR and FTR in the occurrence of either overall ARE (HR = 1.01, p = 0.9675) or steroid-resistant ARE (HR = 1.27, p = 0.4087). CONCLUSIONS: The risk of graft failure following second transplantation remained consistently higher than that observed in first transplantation after adjusting for confounding factors. The rarely performed time-dependent statistical modeling may explain the heterogeneous conclusions of the literature concerning second transplantation outcomes. In clinical practice, physicians should not consider STR and FTR equally.
Projet(s) ayant donné lieu à cette publication
Thèse(s) ou stage(s) lié(s) à cette publication
Katy Trébern-Launay : Apport des modèles de survie relative dans la modélisation des patients transplantés rénaux : application à la cohorte DIVAT (soutenue le 24 octobre 2013)
Publications ayant le même axe principal de recherche (Modèles pronostiques)
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Br J Dermatol, 174(1): 146-51.Le Fur A ,Fournier MC ,Gillaizeau F ,Masson D ,Giral M ,Cariou B ,Cantarovich D ,Dantal J (2015) Vitamin D deficiency is an independent risk factor for PTDM after kidney transplantation.. Transplant international: .Chapal M ,Foucher Y ,Marquette C ,Néau K ,Papuchon E ,Daguin P ,Morelon E ,Mourad G ,Castillo J ,Ladrière M ,Legendre C ,Giral M (2015) PREventing Delayed Graft Function by Driving Immunosuppressive InduCtion Treatment (PREDICT-DGF): study protocol for a randomized controlled trial. Trials, 16(1): 282.Gillaizeau F ,Dantan E ,Giral M ,Foucher Y (2015) A multistate additive relative survival semi-Markov model. Statistical Methods in Medical Research, 26(4): 1700-1711.-
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Foucher Y (2013) Modélisation et pronostic de l'évolution de pathologies chroniques : Applications en transplantation renale. , 193. Danger R ,Foucher Y (2012) Time dependent ROC curves for the estimation of true prognostic capacity of microarray data. Statistical Applications in Genetics and Molecular Biology, 11(6): Article 1.Combescure C ,Daurès JP ,Foucher Y (2012) A literature-based approach to evaluate the predictive capacity of a marker using time-dependent summary receiver operating characteristics. Stat Methods Med Res: online first.Foucher Y ,Combescure C ,Ashton-Chess J ,Giral M (2012) Prognostic Markers: Data Misinterpretation Often Leads to Overoptimistic Conclusions. Am J Transplant, 12(4): 1060-1.Foucher Y ,Giral M ,Soulillou JP ,Daurès JP (2012) Cut-off estimation and medical decision making based on a continuous prognostic factor : the prediction of kidney graft failure. Int J Biostat, 8(1): 1–13.Degauque N ,Boeffard F ,Foucher Y ,Ballet C ,Brouard S ,Soulillou JP (2011) The Blood of Healthy Individuals Exhibits CD8 T Cells with a Highly Altered TCR Vb Repertoire but with an Unmodified Phenotype. PLoS One, 6(6): e21240.Brouard S ,Le Bars A ,Dufay A ,Gosselin M ,Foucher Y ,Guillet M ,Cesbron A ,Thervet E ,Legendre C ,Dugast E ,Pallier A ,Guillot-Gueguen C ,Lagoutte L ,Evanno G ,Giral M ,Soulillou JP (2011) Identification of a gene expression profile associated with operational tolerance among a selected group of stable kidney transplant patients. Transplantation International, 24(6): 536-547.Foucher Y ,Giral M ,Soulillou JP ,Daurès JP (2010) Time-dependent ROC analysis for a three-class prognostic with application to kidney transplantation. Statistics in Medicine, 29(30): 3079-87.Foucher Y ,Daguin P ,Akl A ,Kessler M ,Ladrière M ,Legendre C ,Kreiss H ,Kamar N ,Rostaing L ,Garrigue V ,Bayle F ,de Ligny B ,Buchler M ,Meier C ,Soulillou JP ,Giral M (2010) A clinical scoring system highly predictive of long-term kidney graft survival.. Kidney International, 78(12): 1288-94.Foucher Y ,Giral M ,Soulillou JP ,Daurès JP (2010) A flexible semi-Markov model for interval-censored data and goodness-of-fit testing. Statistical Methods in Medical Research, 19(2): 127-45.Ladrière M ,Foucher Y ,Legendre C ,Kamar N ,Garrigue V ,Morelon E ,Kressler M ,Soulillou JP ,Giral M (2010) The Western Europe Cohort Of Kidney Transplanted Recipients - The DIVAT Network. In Clinical Transplants (J. Michael Cecka and Paul I. Terasaki): Terasaki Foundation Laboratory.Foucher Y ,Daguin P ,Kessler M ,Ladrière M ,Legendre C ,Kreiss H ,Durand D ,Mourad G ,Garrigue V ,Soulillou JP ,Giral M (2008) How well do pre- and peritransplant variables predict the long-term results of kidney transplantation?. In Clinical Transplants - Chapter 10 (J. Michael Cecka and Paul I. Terasaki): Terasaki Foundation Laboratory.Foucher Y ,Daguin P ,Kessler M ,Laveyssiere L ,Legendre C ,Kreiss H ,Durand D ,Layrolle P ,Mourad G ,Garrigue V ,Daurès JP ,Soulillou JP ,Giral M (2008) How to evaluate the long-term prognostic capacity of pre-graft variables in transplantation?. Clinical Transplant: 113-8.Foucher Y ,Giral M ,Soulillou JP ,Daurès JP (2007) A semi-Markov model for multistate and interval-censored data with multiple terminal events. Application in renal transplantatio. Statistics in Medicine, 26(30): 5381-93.Castelli C ,Combescure C ,Foucher Y ,Daurès JP (2007) Cost-effectiveness analysis in colo-rectal cancer using a semi-Markov model. Statistics in Medicine, 26(30): 5557-71.Foucher Y (2007) Modèles semi-Markoviens : Application à l'analyse de l'évolution de pathologies chroniques. Thèse de doctorat de l'Université Montpellier 1, 184.Mathieu E ,Foucher Y ,Dellamonica P ,Daurès JP (2007) A Parametric and Non Homogeneous Semi-Markov Process for HIV control. Methodology and Computing in Applied Probability, 9(3): 389-97.Foucher Y ,Saint-Pierre P ,Puglièse P ,Daurès JP (2006) A Semi-Markov Frailty Model for Multistate Survival Data : Illustration on HIV Disease. Far East Journal of Theoretical Statistics, 19: 185-201.Foucher Y ,Mathieu E ,Saint-Pierre P ,Durand JF ,Daurès JP (2005) A semi-Markov model based on Generalized Weibull distribution with an illustration for HIV disease. Biometrical Journal, 47(6): 825-33.Giral M ,NGuyen JM ,Karam G ,Kessler M ,Hurault de Ligny B ,Buchler M ,Bayle F ,Meyer C ,Foucher Y ,Martin ML ,Daguin P ,Soulillou JP (2005) Impact of graft mass in the clinical outcome of kidney transplants. Journal of the American Society of Nephrology, 16: 261-268.
Publications liées à l'axe principal de recherche (Modèles pronostiques)
Chapal M ,Néel M ,Le Borgne F ,Meffray E ,Carceles O ,Hourmant M ,Giral M ,Foucher Y ,Moreau A ,Fakhouri F (2013) Increased soluble flt-1 correlates with delayed graft function and early loss of peritubular capillaries in the kidney graft. Transplantation, 96(8): 739-44.Cantarovich D ,Hodemon-Corne B ,Trébern-Launay K ,Giral M ,Foucher Y ,Dantan E (2013) Early steroid withdrawal compared with steroid avoidance correlates with graft failure among kidney transplant recipients with an history of diabetes. Transplantation Procedings, 45(4): 1497-502.Danger R ,Paul C ,Giral M ,Foucher Y ,Degauque N ,Pallier A ,Durand M ,Castagnet S ,Duong Van Huyen J ,Delahousse M ,Renaudin K ,Soulillou JP ,Brouard S (2013) Expression of miR-142-5p in peripheral blood mononuclear cells from renal transplant patients with chronic antibody-mediated rejection. PLoS One, 8(4): e60702.Thibaud A ,Foucher Y ,Danger R ,Migone T ,Pallier A ,Castelli C ,Castagnet S ,Devys A ,Cesbron A ,Giral M ,Soulillou JP ,Brouard S (2012) BAFF and BAFF-R levels are associated with risk of long-term kidney graft dysfunction and development of donor-specific antibodies. Am J Transplant, 12(10): 2754-62.Racapé M ,Duong Van Huyen J ,Danger R ,Giral M ,Bleicher F ,Foucher Y ,Pallier A ,Pilet P ,Tafelmeyer P ,Ashton-Chess J ,Dugast E ,Pettre S ,Charreau B ,Soulillou JP ,Brouard S (2011) The involvement of SMILE/TMTC3 in endoplasmic reticulum stress response. PLoS One, 6(5): e19321.Dahyot-Fizelier C ,Frasca D , Lasocki S, Asehnoune K, Balayn D, Guerin AL, Perrigault PF, Geeraerts T, Seguin P, Rozec B, Elaroussi D, Cottenceau V, Guyonnaud C, Mimoz O; PROPHY-VAP Study group, ATLANREA group. Prevention of early ventilation-acquired pneumonia (VAP) in comatose brain-injured patients by a single dose of ceftriaxone: PROPHY-VAP study protocol, a multicentre, randomised, double-blind, placebo-controlled trial.. , 8(10): .