Abstract
Background: Chronic lung allograft dysfunction and its main phenotypes, bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS), are major causes of mortality after lung transplantation (LT). RAS and early-onset BOS, developing within 3 years after LT, are associated with particularly inferior clinical outcomes. Prediction models for early-onset BOS and RAS have not been previously described. Methods: LT recipients of the French and Swiss transplant cohorts were eligible for inclusion in the SysCLAD cohort if they were alive with at least 2 years of follow-up but less than 3 years, or if they died or were retransplanted at any time less than 3 years. These patients were assessed for early-onset BOS, RAS, or stable allograft function by an adjudication committee. Baseline characteristics, data on surgery, immunosuppression, and year-1 follow-up were collected. Prediction models for BOS and RAS were developed using multivariate logistic regression and multivariate multinomial analysis. Results: Among patients fulfilling the eligibility criteria, we identified 149 stable, 51 BOS, and 30 RAS subjects. The best prediction model for early-onset BOS and RAS included the underlying diagnosis, induction treatment, immunosuppression, and year-1 class II donor-specific antibodies (DSAs). Within this model, class II DSAs were associated with BOS and RAS, whereas pre-LT diagnoses of interstitial lung disease and chronic obstructive pulmonary disease were associated with RAS. Conclusion: Although these findings need further validation, results indicate that specific baseline and year-1 parameters may serve as predictors of BOS or RAS by 3 years post-LT. Their identification may allow intervention or guide risk stratification, aiming for an individualized patient management approach.
Original language | English |
---|---|
Article number | 109 |
Number of pages | 15 |
Journal | Frontiers in Medicine |
Volume | 4 |
Issue number | JUL |
DOIs | |
Publication status | Published - 1 Jan 2017 |
Externally published | Yes |
Keywords
- Bronchiolitis obliterans syndrome
- Chronic lung allograft dysfunction
- Chronic rejection
- Predictive model
- Restrictive allograft syndrome
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Development of a multivariate prediction model for early-onset bronchiolitis obliterans syndrome and restrictive allograft syndrome in lung transplantation. / Koutsokera, Angela; Royer, P. J.; Antonietti, Jean P.; Fritz, Andreas; Benden, Christian; Aubert, John D.; Tissot, A.; Botturi, Karine; Roux, Antoine; Reynaud-Gaubert, Martine L.; Kessler, Romain; Dromer, C.; Mussot, S.; Mal, H.; Mornex, J. F.; Guillemain, R.; Knoop, C.; Dahan, Marcel; Soccal, Paola M.; Claustre, J.; Sage, Edouard; Gomez, C.; Magnan, Antoine; Piso, Christophe; Nicod, Laurent P.; The SysCLAD Consortium.
In: Frontiers in Medicine, Vol. 4, No. JUL, 109, 01.01.2017.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Development of a multivariate prediction model for early-onset bronchiolitis obliterans syndrome and restrictive allograft syndrome in lung transplantation
AU - Koutsokera, Angela
AU - Royer, P. J.
AU - Antonietti, Jean P.
AU - Fritz, Andreas
AU - Benden, Christian
AU - Aubert, John D.
AU - Tissot, A.
AU - Botturi, Karine
AU - Roux, Antoine
AU - Reynaud-Gaubert, Martine L.
AU - Kessler, Romain
AU - Dromer, C.
AU - Mussot, S.
AU - Mal, H.
AU - Mornex, J. F.
AU - Guillemain, R.
AU - Knoop, C.
AU - Dahan, Marcel
AU - Soccal, Paola M.
AU - Claustre, J.
AU - Sage, Edouard
AU - Gomez, C.
AU - Magnan, Antoine
AU - Piso, Christophe
AU - Nicod, Laurent P.
AU - Jougon, J.
AU - Velly, J. F.
AU - Rozé, H.
AU - Blanchard, E.
AU - Dromer, C.
AU - Antoine, M.
AU - Cappello, M.
AU - Ruiz, M.
AU - Sokolow, Y.
AU - Vanden Eynden, F.
AU - Van Nooten, G.
AU - Barvais, L.
AU - Berré, J.
AU - Brimioulle, S.
AU - De Backer, D.
AU - Créteur, J.
AU - Engelman, E.
AU - Huybrechts, I.
AU - Ickx, B.
AU - Preiser, T. J.C.
AU - Tuna, T.
AU - Van Obberghe, L.
AU - Vancutsem, N.
AU - Vincent, J. L.
AU - De Vuyst, P.
AU - Etienne, I.
AU - Féry, F.
AU - Jacobs, F.
AU - Knoop, C.
AU - Vachiéry, J. L.
AU - Van den Borne, P.
AU - Wellemans, I.
AU - Amand, G.
AU - Collignon, L.
AU - Giroux, M.
AU - Arnaud-Crozat, E.
AU - Bach, V.
AU - Brichon, P. Y.
AU - Chaffanjon, P.
AU - Chavanon, O.
AU - de Lambert, A.
AU - Fleury, J. P.
AU - Guigard, S.
AU - Hacini, R.
AU - Hireche, K.
AU - Pirvu, A.
AU - Porcu, P.
AU - Albaladejo, P.
AU - Allègre, C.
AU - Bataillard, A.
AU - Bedague, D.
AU - Briot, E.
AU - Casez-Brasseur, M.
AU - Colas, D.
AU - Dessertaine, G.
AU - Durand, M.
AU - Francony, G.
AU - Hebrard, A.
AU - Marino, M. R.
AU - Oummahan, B.
AU - Protar, D.
AU - Rehm, D.
AU - Robin, S.
AU - Rossi-Blancher, M.
AU - Augier, C.
AU - Bedouch, P.
AU - Boignard, A.
AU - Bouvaist, H.
AU - Brambilla, E.
AU - Briault, A.
AU - Camara, B.
AU - Claustre, J.
AU - Chanoine, S.
AU - Dubuc, M.
AU - Quétant, S.
AU - Maurizi, J.
AU - Pavèse, P.
AU - Pison, C.
AU - Saint-Raymond, C.
AU - Wion, N.
AU - Chérion, C.
AU - Grima, R.
AU - Jegaden, O.
AU - Maury, J. M.
AU - Tronc, F.
AU - Flamens, C.
AU - Paulus, S.
AU - Mornex, J. F.
AU - Philit, F.
AU - Senechal, A.
AU - Glérant, C.
AU - Turquier, S.
AU - Gamondes, D.
AU - Chalabresse, L.
AU - Thivolet-Bejui, F.
AU - Barnel, C.
AU - Dubois, C.
AU - Tiberghien, A.
AU - Le Pimpec-Barthes, F.
AU - Bel, A.
AU - Mordant, P.
AU - Achouh, P.
AU - Boussaud, V.
AU - Guillemain, R.
AU - Méléard, D.
AU - Bricourt, M. O.
AU - Cholley, B.
AU - Pezella, V.
AU - Brioude, G.
AU - D'Journo, X. B.
AU - Doddoli, C.
AU - Thomas, P.
AU - Trousse, D.
AU - Dizier, S.
AU - Leone, M.
AU - Papazian, L.
AU - Bregeon, F.
AU - Basire, A.
AU - Coltey, B.
AU - Dufeu, N.
AU - Dutau, H.
AU - Garcia, S.
AU - Gaubert, J. Y.
AU - Gomez, C.
AU - Laroumagne, S.
AU - Nieves, A.
AU - Picard, L. C.
AU - Reynaud-Gaubert, M.
AU - Secq, V.
AU - Mouton, G.
AU - Baron, O.
AU - Brossaud, C.
AU - Durand, E.
AU - Durand, M.
AU - Lacoste, P.
AU - Perigaud, C.
AU - Roussel, J. C.
AU - Danner, I.
AU - Haloun, A.
AU - Tissot, A.
AU - Lepoivre, T.
AU - Treilhaud, M.
AU - Botturi-Cavaillès, K.
AU - Brouard, S.
AU - Danger, R.
AU - Loy, J.
AU - Morisset, M.
AU - Pain, M.
AU - Pares, S.
AU - Reboulleau, D.
AU - Royer, P. J.
AU - Dartevelle, Ph
AU - Fabre, D.
AU - Fadel, E.
AU - Mercier, O.
AU - Mussot, S.
AU - Stephan, F.
AU - Viard, P.
AU - Cerrina, J.
AU - Dorfmuller, P.
AU - Feuillet, S.
AU - Ghigna, M.
AU - Le Roy Ladurie, Ph Hervén F.
AU - Le Pavec, J.
AU - Thomas de Montpreville, V.
AU - Lamrani, L.
AU - Castier, Y.
AU - Mordant, P.
AU - Cerceau, P.
AU - Augustin, P.
AU - Jean-Baptiste, S.
AU - Boudinet, S.
AU - Montravers, P.
AU - Brugière, O.
AU - Dauriat, G.
AU - Jébrak, G.
AU - Mal, H.
AU - Marceau, A.
AU - Métivier, A. C.
AU - Thabut, G.
AU - Lhuillier, E.
AU - Dupin, C.
AU - Bunel, V.
AU - Falcoz, P.
AU - Massard, G.
AU - Santelmo, N.
AU - Ajob, G.
AU - Collange, O.
AU - Hentz, J.
AU - Roche, A.
AU - Bakouboula, B.
AU - Degot, T.
AU - Dory, A.
AU - Hirschi, S.
AU - Ohlmann-Caillard, S.
AU - Kessler, L.
AU - Kessler, R.
AU - Schuller, A.
AU - Renaud-Picard, B.
AU - Bennedif, K.
AU - Vargas, S.
AU - Bonnette, P.
AU - Chapelier, A.
AU - Puyo, P.
AU - Sage, E.
AU - Bresson, J.
AU - Caille, V.
AU - Cerf, C.
AU - Devaquet, J.
AU - Dumans-Nizard, V.
AU - Felten, M. L.
AU - Fischler, M.
AU - Si Larbi, A. G.
AU - Leguen, M.
AU - Ley, L.
AU - Liu, N.
AU - Trebbia, G.
AU - De Miranda, S.
AU - Douvry, B.
AU - Gonin, F.
AU - Grenet, D.
AU - Hamid, A. M.
AU - Neveu, H.
AU - Parquin, F.
AU - Marsland, B. J.
AU - The SysCLAD Consortium
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Chronic lung allograft dysfunction and its main phenotypes, bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS), are major causes of mortality after lung transplantation (LT). RAS and early-onset BOS, developing within 3 years after LT, are associated with particularly inferior clinical outcomes. Prediction models for early-onset BOS and RAS have not been previously described. Methods: LT recipients of the French and Swiss transplant cohorts were eligible for inclusion in the SysCLAD cohort if they were alive with at least 2 years of follow-up but less than 3 years, or if they died or were retransplanted at any time less than 3 years. These patients were assessed for early-onset BOS, RAS, or stable allograft function by an adjudication committee. Baseline characteristics, data on surgery, immunosuppression, and year-1 follow-up were collected. Prediction models for BOS and RAS were developed using multivariate logistic regression and multivariate multinomial analysis. Results: Among patients fulfilling the eligibility criteria, we identified 149 stable, 51 BOS, and 30 RAS subjects. The best prediction model for early-onset BOS and RAS included the underlying diagnosis, induction treatment, immunosuppression, and year-1 class II donor-specific antibodies (DSAs). Within this model, class II DSAs were associated with BOS and RAS, whereas pre-LT diagnoses of interstitial lung disease and chronic obstructive pulmonary disease were associated with RAS. Conclusion: Although these findings need further validation, results indicate that specific baseline and year-1 parameters may serve as predictors of BOS or RAS by 3 years post-LT. Their identification may allow intervention or guide risk stratification, aiming for an individualized patient management approach.
AB - Background: Chronic lung allograft dysfunction and its main phenotypes, bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS), are major causes of mortality after lung transplantation (LT). RAS and early-onset BOS, developing within 3 years after LT, are associated with particularly inferior clinical outcomes. Prediction models for early-onset BOS and RAS have not been previously described. Methods: LT recipients of the French and Swiss transplant cohorts were eligible for inclusion in the SysCLAD cohort if they were alive with at least 2 years of follow-up but less than 3 years, or if they died or were retransplanted at any time less than 3 years. These patients were assessed for early-onset BOS, RAS, or stable allograft function by an adjudication committee. Baseline characteristics, data on surgery, immunosuppression, and year-1 follow-up were collected. Prediction models for BOS and RAS were developed using multivariate logistic regression and multivariate multinomial analysis. Results: Among patients fulfilling the eligibility criteria, we identified 149 stable, 51 BOS, and 30 RAS subjects. The best prediction model for early-onset BOS and RAS included the underlying diagnosis, induction treatment, immunosuppression, and year-1 class II donor-specific antibodies (DSAs). Within this model, class II DSAs were associated with BOS and RAS, whereas pre-LT diagnoses of interstitial lung disease and chronic obstructive pulmonary disease were associated with RAS. Conclusion: Although these findings need further validation, results indicate that specific baseline and year-1 parameters may serve as predictors of BOS or RAS by 3 years post-LT. Their identification may allow intervention or guide risk stratification, aiming for an individualized patient management approach.
KW - Bronchiolitis obliterans syndrome
KW - Chronic lung allograft dysfunction
KW - Chronic rejection
KW - Predictive model
KW - Restrictive allograft syndrome
UR - http://www.scopus.com/inward/record.url?scp=85040511460&partnerID=8YFLogxK
U2 - 10.3389/fmed.2017.00109
DO - 10.3389/fmed.2017.00109
M3 - Article
AN - SCOPUS:85040511460
VL - 4
JO - Frontiers in Medicine
JF - Frontiers in Medicine
SN - 2296-858X
IS - JUL
M1 - 109
ER -