Using a network approach to define relationships among tests for kidney transplant antibody-mediated rejection in a cross-sectional study.
Ontology highlight
ABSTRACT:
PROVIDER: PRJNA1216662 | ENA |
REPOSITORIES: ENA
Similar Datasets
Project description:Effective therapies for kidney transplant antibody-mediated rejection (ABMR) (Mayer et al, 2024) will require accurate diagnoses plus assessment of ABMR activity, and the new tests that were used to show treatment effects in the clinical trial such as donor-derived cell-free DNA (dd-cfDNA) and molecular biopsy analysis (MMDx) could be useful. ). In a partial correlation network, all four tests were correlated, in a hierarchy of inter-test correlations: MMDx ABMR > dd-cfDNA > histology ABMR > and DSA. Surprisingly, DSA correlated at least as strongly with MMDx ABMR as with histologic ABMR, even though DSA is not used in MMDx. When expressed in the same six rejection classes, MMDx diagnosed ABMR more frequently than histology. When histology disagreed with MMDx ABMR, dd-cfDNA, and DSA correlated more strongly with MMDx assessment. However, histology also detected ABMR lesions in some cases that MMDx called no rejection, correlating with subthreshold molecular ABMR activity and dd-cfDNA and DSA (AJT 25:72-87, 2024). Thus, the four-way inter-test correlations extend below current thresholds for diagnosing ABMR. Molecular rejection predicted outcomes better than histologic rejection in Trifecta, confirmed in the earlier INTERCOMEX study. These results map a network of four ABMR-related tests that can add precision to ABMR assessment in trials and clinical management and highlight the need to establish the clinical significance of subthreshold ABMR activity.
2025-07-23 | GSE288273 | GEO
Project description:Four tests assess antibody-mediated rejection (ABMR) in heart transplants: standard of care local endomyocardial biopsy (EMB) histology, EMB molecular analysis (Molecular Microscope® Diagnostic System - MMDx), donor-derived cell-free DNA (dd-cfDNA), and donor-specific antibody (DSA). These tests have become critical for the development and use of novel therapies for ABMR. The Trifecta-Heart study (NCT04707872) aimed to define the relationships among these tests. MMDx diagnosed more ABMR, TCMR, and No rejection (NR) than histology, a pattern confirmed in a validation set from the larger INTERHEART study (NCT02670408). When correlations and partial correlation modeling were used to defined the hierarchy of relationships among all tests, MMDx ABMR correlated more strongly with dd-cfDNA and DSA than did histologic ABMR. In MMDx-histology discrepancies, biopsies with no histologic rejection but with MMDx ABMR had elevated DSA and dd-cfDNA, and biopsies with MMDx NR but histology ABMR had low DSA and dd-cfDNA. DSA-negative ABMR by MMDx or histology had elevated dd-cfDNA, similar to DSA-positive ABMR. Most cases with molecular injury and high dd-cfDNA also had concurrent molecular rejection. These inter-test relationships will be useful in guiding ABMR management, including monitoring of treatment responses and relapses, especially when discrepancies occur.
2026-06-22 | GSE303541 | GEO
Project description:Defining the relationships among four tests with antibody-mediated rejection in heart transplants
| PRJNA1295773 | ENA
Project description: Not available
| S-EPMC12446986 | biostudies-literature
Project description:PBMC samples from heart transplant patients were profiled. Sample classification was based on endomyocardial biopsy at the time of sample collection. Keywords = Transplant Keywords = Transplantation Keywords = Heart Transplant Keywords = Graft Rejection Keywords = Rejection Keywords = PBMC Keywords = Immune Response Keywords = Peripheral Blood
2010-06-10 | E-GEOD-2445 | biostudies-arrayexpress
Project description:PBMC samples from heart transplant patients were profiled. Sample classification was based on endomyocardial biopsy at the time of sample collection. Keywords = Transplant Keywords = Transplantation Keywords = Heart Transplant Keywords = Graft Rejection Keywords = Rejection Keywords = PBMC Keywords = Immune Response Keywords = Peripheral Blood Keywords: other
2005-09-01 | GSE2445 | GEO
Project description:Short-term kidney transplant rejection rates have vastly improved. Unfortunately, the focus is still on clinical acute rejection, whereas patients with no graft dysfunction and subclinical rejection without protocol biopsies would be treated as having no ongoing injury. Molecular diagnostic tests to detect rejection are still reliant on the current gold standard, kidney histology. Our work is the first to examine molecular profiles in matched tissue and blood samples from a prevalent kidney transplant recipient population. We show molecular evidence, in blood and tissue, that subclinical rejection is a precursor of clinical rejection and that non-alloimmune injury to the graft can be distinguished from immune activation. Our work supports consideration of tissue molecular profiling for a comprehensive understanding of noninvasive diagnostics.
2025-12-01 | GSE249451 | GEO
Project description:Background: Initial analysis of liver transplant biopsies in the INTERLIVER study (#NCT03193151) using rejection-associated transcripts failed to find an antibody-mediated rejection state (i.e. rich in NK cells and with interferon-gamma effects). We recently developed an optimization strategy in lung transplants that isolated an NK cell-enriched rejection-like state (NKRL) that was molecularly distinct from T cell-mediated rejection (TCMR). Here we apply the same strategy to a liver transplant biopsy population. Results: The full model classified 765 biopsies into the following molecular phenotypes, characterized by their gene expression: No-rejection (NR) 54%; TCMR 16%; NKRL 13%; and Injury 16%. Top TCMR transcripts were expressed in effector T cells; top NKRL transcripts were almost exclusively expressed in NK cells; and both had increased IFNG-inducible transcripts, which were more pronounced in TCMR. Most TCMR biopsies had significant parenchymal injury, molecular fibrosis, and abnormal biochemistry. NKRL biopsies had no excess of injury, fibrosis, or biochemistry abnormalities. Conclusions: Optimized rejection algorithms indicate that some liver transplants manifest an NKRL state that is well-tolerated in the short-term postbiopsy and with minimal injury and relatively normal biochemistry, while also underscoring the potential of TCMR to produce extensive parenchymal injury.
2025-07-03 | GSE277334 | GEO
Project description:The first-generation Molecular Microscope® (MMDx) system for heart transplant endomyocardial biopsies used expression of rejection-associated transcripts (RATs) to diagnose T cell-mediated rejection (TCMR) and antibody-mediated rejection (ABMR) but also detected acute injury. However, the ideal system should detect rejection without being influenced by injury, to permit analysis of the relationship between rejection and parenchymal injury. To achieve this, we developed a new rejection classification in an expanded cohort of 3230 biopsies: 1641 from INTERHEART (ClinicalTrials.gov #NCT02670408), plus 1589 service biopsies added to improve the power of the machine learning algorithms. The new system used six rejection classifiers instead of RATs and generated seven rejection archetypes: No Rejection 48%; Minor 24%; TCMR1 2.3%; TCMR2 2.7%; TCMR/Mixed 2.7%; EABMR 3.9%; and FABMR 16%. Using rejection classifiers eliminated cross-reactions with acute injury, permitting separate assessment of rejection and injury. TCMR was associated with severe recent injury and late atrophy-fibrosis and rarely had normal parenchyma. ABMR was better tolerated, seldom producing severe injury, but in later biopsies was often associated with atrophy-fibrosis, indicating long term risk. Graft survival and LVEF were reduced in hearts with TCMR, but also in hearts with severe-recent injury and atrophy-fibrosis, even without rejection.
2024-04-02 | GSE262742 | GEO
Project description:Defining a NK cell-enriched molecular rejection-like state in lung transplant transbronchial biopsies
| PRJNA1295761 | ENA