Derivation and external validation of the SIMPLICITY score as a simple immune-based risk score to predict infection in kidney transplant recipients
Copyright © 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved..
Existing approaches for infection risk stratification in kidney transplant recipients are suboptimal. Here, we aimed to develop and validate a weighted score integrating non-pathogen-specific immune parameters and clinical variables to predict the occurrence of post-transplant infectious complications. To this end, we retrospectively analyzed a single-center derivation cohort of 410 patients undergoing kidney transplantation in 2008-2013 in Madrid. Peripheral blood lymphocyte subpopulations, serum immunoglobulin and complement levels were measured at one-month post-transplant. The primary and secondary outcomes were overall and bacterial infection through month six. A point score was derived from a logistic regression model and prospectively applied on a validation cohort of 522 patients undergoing kidney transplantation at 16 centers throughout Spain in 2014-2015. The SIMPLICITY score consisted of the following variables measured at month one after transplantation: C3 level, CD4+ T-cell count, CD8+ T-cell count, IgG level, glomerular filtration rate, recipient age, and infection within the first month. The discrimination capacity in the derivation and validation cohorts was good for overall (areas under the receiver operating curve of 0.774 and 0.730) and bacterial infection (0.767 and 0.734, respectively). The cumulative incidence of overall infection significantly increased across risk categories in the derivation (low-risk 13.7%; intermediate-risk, 35.9%; high-risk 77.6%) and validation datasets (10.2%, 28.9% and 50.4%, respectively). Thus, the SIMPLICITY score, based on easily available immune parameters, allows for stratification of kidney transplant recipients at month one according to their expected risk of subsequent infection.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:98 |
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| Enthalten in: |
Kidney international - 98(2020), 4 vom: 15. Okt., Seite 1031-1043 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fernández-Ruiz, Mario [VerfasserIn] |
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| Links: |
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| Themen: |
Immune biomarkers |
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| Anmerkungen: |
Date Completed 21.06.2021 Date Revised 21.06.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.kint.2020.04.054 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM311194710 |
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| 245 | 1 | 0 | |a Derivation and external validation of the SIMPLICITY score as a simple immune-based risk score to predict infection in kidney transplant recipients |
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| 520 | |a Copyright © 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Existing approaches for infection risk stratification in kidney transplant recipients are suboptimal. Here, we aimed to develop and validate a weighted score integrating non-pathogen-specific immune parameters and clinical variables to predict the occurrence of post-transplant infectious complications. To this end, we retrospectively analyzed a single-center derivation cohort of 410 patients undergoing kidney transplantation in 2008-2013 in Madrid. Peripheral blood lymphocyte subpopulations, serum immunoglobulin and complement levels were measured at one-month post-transplant. The primary and secondary outcomes were overall and bacterial infection through month six. A point score was derived from a logistic regression model and prospectively applied on a validation cohort of 522 patients undergoing kidney transplantation at 16 centers throughout Spain in 2014-2015. The SIMPLICITY score consisted of the following variables measured at month one after transplantation: C3 level, CD4+ T-cell count, CD8+ T-cell count, IgG level, glomerular filtration rate, recipient age, and infection within the first month. The discrimination capacity in the derivation and validation cohorts was good for overall (areas under the receiver operating curve of 0.774 and 0.730) and bacterial infection (0.767 and 0.734, respectively). The cumulative incidence of overall infection significantly increased across risk categories in the derivation (low-risk 13.7%; intermediate-risk, 35.9%; high-risk 77.6%) and validation datasets (10.2%, 28.9% and 50.4%, respectively). Thus, the SIMPLICITY score, based on easily available immune parameters, allows for stratification of kidney transplant recipients at month one according to their expected risk of subsequent infection | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a SIMPLICITY score | |
| 650 | 4 | |a immune biomarkers | |
| 650 | 4 | |a infection | |
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| 700 | 1 | |a Seron, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Alonso, Ángel |e verfasserin |4 aut | |
| 700 | 1 | |a Lora, David |e verfasserin |4 aut | |
| 700 | 1 | |a Hernández, Domingo |e verfasserin |4 aut | |
| 700 | 1 | |a González, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez-Sáez, María José |e verfasserin |4 aut | |
| 700 | 1 | |a Gómez, Gonzalo |e verfasserin |4 aut | |
| 700 | 1 | |a Pallardó-Mateu, Luis Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Jimeno-García, Luisa |e verfasserin |4 aut | |
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| 700 | 1 | |a Gutierrez-Dalmau, Alex |e verfasserin |4 aut | |
| 700 | 1 | |a Ruiz, Juan Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Ramírez-Puga, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Santana Estupiñán, Raquel |e verfasserin |4 aut | |
| 700 | 1 | |a Marcén, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Portolés, José María |e verfasserin |4 aut | |
| 700 | 1 | |a Muñoz-Cepeda, Miguel Ángel |e verfasserin |4 aut | |
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| 700 | 1 | |a Andrés, Amado |e verfasserin |4 aut | |
| 700 | 1 | |a Aguado, José María |e verfasserin |4 aut | |
| 700 | 0 | |a Spanish Network for Research in Infectious Diseases (REIPI RD16/0016) and Spanish Network for Research in Renal Diseases (REDinREN RD16/0009) |e verfasserin |4 aut | |
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