Development and validation of a bronchoalveolar lavage genomic classifier for acute cellular rejection.

ABSTRACT:

Background

Acute cellular rejection (ACR) is the main risk factor for chronic lung allograft dysfunction (CLAD), but diagnosis requires invasive transbronchial biopsy (TBB). We previously demonstrated the feasibility of bronchoalveolar lavage cell pellet (BAL-cp) gene expression for ACR diagnosis. We sought to develop and validate a genomic classifier for ACR in a multicenter cohort.

Methods

We performed RNA-seq on 806 BAL-cp from 181 lung transplant recipients enrolled in CTOT-20. Differential expression was based on fold difference >2.0 and False Discovery adjusted p-value <0.05. Samples were randomly split 80:20 into training and testing sets. A Random Forest model was optimized for area under the curve (AUC), and the threshold for genomic ACR was selected for classificat

SUBMITTER: Weigt SS 

PROVIDER: S-EPMC12719680 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature