부산대학교 도서관

Summary: Surveillance biopsies after renal transplantation remain debatable. To drive the decision of such intervention, we propose a predictive score of abnormal histology at 1‐year post‐transplantation, named 1‐year Renal Biopsy Index (1‐RBI). We studied 466 kidney recipients from the DIVAT cohort alive with a functioning graft and a surveillance biopsy at 1‐year post‐transplantation. Patients displaying abnormal histology (49%) (borderline, acute rejection, interstitial fibrosis and tubular atrophy [IFTA] grade 2 or 3, glomerulonephritis) were compared to the normal or subnormal (IFTA grade 1) histology group. Obtained from a lasso penalized logistic regression, the 1‐RBI was composed of recipient gender, serum creatinine at 3, 6, and 12 month post‐transplantation and anticlass II immunization at transplantation (internal validation: AUC = 0.71, 95% CI [0.53–0.83]; external validation: AUC = 0.62, 95% CI [0.58–0.66]). While we could not determinate a threshold able to identify patients at high chance of normal or subnormal histology, we estimated and validated a discriminating threshold capable of identifying a subgroup of 15% of the patients with a risk of abnormal histology higher than 80%. The 1‐RBI is computable online at www.divat.fr. The 1‐RBI could be a useful tool to standardize 1‐year biopsy proposal and may for instance help to indicate one in case of high risk of abnormal histology. [ABSTRACT FROM AUTHOR]