Can We Predict Graft Intolerance Syndrome After Kidney Transplant Failure? External Validation of a Previously Developed Model

Kim Bunthof, Khalid Saboerali, Jacqueline Van De Wetering, Azam Nurmohamed, Frederike Bemelman, Arjan Van Zuilen, Jan Van Den Brand, Marije Baas, Luuk Hilbrands*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Previously we established a prediction model for graft intolerance syndrome requiring graft nephrectomy in patients with late kidney graft failure. The aim of this study is to determine generalizability of this model in an independent cohort. The validation cohort included patients with late kidney graft failure between 2008 and 2018. Primary outcome is the prognostic performance of our model, expressed as the area under the receiver operating characteristic curve (ROC-AUC), in the validation cohort. In 63 of 580 patients (10.9%) a graft nephrectomy was performed because of graft intolerance. The original model, which included donor age, graft survival and number of acute rejections, performed poorly in the validation cohort (ROC-AUC 0.61). After retraining of the model using recipient age at graft failure instead of donor age, the model had an average ROC-AUC of 0.70 in the original cohort and of 0.69 in the validation cohort. Our original model did not accurately predict the graft intolerance syndrome in a validation cohort. However, a retrained model including recipient age at graft failure instead of donor age performed moderately well in both the development and validation cohort enabling identification of patients with the highest and lowest risk of graft intolerance syndrome.

Original languageEnglish
Article number11147
Number of pages7
JournalTransplant International
Volume36
DOIs
Publication statusPublished - 5 May 2023

Keywords

  • Humans
  • Kidney Transplantation/adverse effects
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • Syndrome
  • Tissue Donors
  • prediction model
  • graft intolerance syndrome
  • kidney graft failure
  • external validation
  • graft nephrectomy

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