title: Mortality Prediction after the First Year of Kidney Transplantation: An Observational Study on Two European Cohorts.
abstract: After the first year post transplantation, prognostic mortality scores in kidney transplant recipients can be useful for personalizing medical management. We developed a new prognostic score based on 5 parameters and computable at 1-year post transplantation. The outcome was the time between the first anniversary of the transplantation and the patient's death with a functioning graft. Afterwards, we appraised the prognostic capacities of this score by estimating time-dependent Receiver Operating Characteristic (ROC) curves from two prospective and multicentric European cohorts: the DIVAT (Données Informatisées et VAlidées en Transplantation) cohort composed of patients transplanted between 2000 and 2012 in 6 French centers; and the STCS (Swiss Transplant Cohort Study) cohort composed of patients transplanted between 2008 and 2012 in 6 Swiss centers. We also compared the results with those of two existing scoring systems: one from Spain (Hernandez et al.) and one from the United States (the Recipient Risk Score, RRS, Baskin-Bey et al.). From the DIVAT validation cohort and for a prognostic time at 10 years, the new prognostic score (AUC = 0.78, 95%CI = [0.69, 0.85]) seemed to present significantly higher prognostic capacities than the scoring system proposed by Hernandez et al. (p = 0.04) and tended to perform better than the initial RRS (p = 0.10). By using the Swiss cohort, the RRS and the the new prognostic score had comparable prognostic capacities at 4 years (AUC = 0.77 and 0.76 respectively, p = 0.31). In addition to the current available scores related to the risk to return in dialysis, we recommend to further study the use of the score we propose or the RRS for a more efficient personalized follow-up of kidney transplant recipients.
authors.affiliation: EA 4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology. Nantes University, Nantes, France.|Transplantation, Urology and Nephrology Institute (ITUN)-INSERM U1064, CHU Nantes, Nantes, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Lorent
authors.affiliation: Transplantation, Urology and Nephrology Institute (ITUN)-INSERM U1064, CHU Nantes, Nantes, France.|CIC Biotherapy, CHU Nantes, Nantes, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Giral
authors.affiliation: Transplantation Center, CHUV and University of Lausanne, Lausanne, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pascual
authors.affiliation: Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Koller
authors.affiliation: Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
authors.forename: Jürg
authors.initials: J
authors.lastname: Steiger
authors.affiliation: EA 4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology. Nantes University, Nantes, France.|Transplantation, Urology and Nephrology Institute (ITUN)-INSERM U1064, CHU Nantes, Nantes, France.
authors.forename: Katy
authors.initials: K
authors.lastname: Trébern-Launay
authors.affiliation: Service de Transplantation Rénale et de Soins Intensifs, Hôpital Necker, APHP Paris, Paris, France.|Universités Paris Descartes et Sorbonne Paris Cité, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Legendre
authors.affiliation: Service de Transplantation Rénale et de Soins Intensifs, Hôpital Necker, APHP Paris, Paris, France.|Universités Paris Descartes et Sorbonne Paris Cité, Paris, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Kreis
authors.affiliation: Service de Néphrologie-Transplantation, Hôpital Lapeyronie, Montpellier, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Mourad
authors.affiliation: Service de Néphrologie-Transplantation, Hôpital Lapeyronie, Montpellier, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Garrigue
authors.affiliation: Service de Néphrologie, HTA, Dialyse et Transplantation d'Organes, CHU Rangueil, Toulouse, France.|Université Paul Sabatier, Toulouse, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
authors.affiliation: Service de Néphrologie, HTA, Dialyse et Transplantation d'Organes, CHU Rangueil, Toulouse, France.|Université Paul Sabatier, Toulouse, France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.affiliation: Service de Transplantation Rénale, CHU Brabois, Nancy, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Kessler
authors.affiliation: Service de Transplantation Rénale, CHU Brabois, Nancy, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Ladrière
authors.affiliation: Service de Néphrologie, Transplantation et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Morelon
authors.affiliation: Service de Néphrologie, Transplantation et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Buron
authors.affiliation: Transplantation Center, CHUV and University of Lausanne, Lausanne, Switzerland.
authors.forename: Dela
authors.initials: D
authors.lastname: Golshayan
authors.affiliation: EA 4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology. Nantes University, Nantes, France.|Transplantation, Urology and Nephrology Institute (ITUN)-INSERM U1064, CHU Nantes, Nantes, France.
authors.forename: Yohann
authors.initials: Y
authors.lastname: Foucher
mesh_terms: D015331:Cohort Studies; D003657:Decision Making; D005060:Europe; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis