Early but not late allograft nephrectomy reduces allosensitization after transplant failure
Bibliographic record
Abstract
Introduction: Allosensitization is a significant obstacle to retransplantationfor patients with primary renal graft failure.Methods: We assessed the impact of allograft nephrectomy(Group I) and weaning of immunosuppression (Group II) on percentpanel reactive antibody (%PRA) at various time points after graftfailure in 132 patients with a median follow-up of 47 months. Ofthese, 68% had allograft nephrectomy while 32% were placed onthe waiting list and were either taken off immunosuppression, lefton prednisone or on low-dose immunosuppressive therapy.Results: When groups were stratified into early (<6 months) andlate (>6 months) graft failure, patients who had transplant nephrectomyfor early failure demonstrated a decline in %PRA from46% at time of graft failure to 27% at last follow-up (p = 0.02);conversely, %PRA continued to rise in Group II experiencing earlyallograft failure. Both Groups I and II patients with late graft failuremaintained elevated %PRA at last follow-up.Conclusion: Allograft nephrectomy may play a role in limitingallosensitization in patients with early but not late graft failures.RésuméIntroduction : L’allosensibilisation est un obstacle important à laretransplantation chez les patients présentant un échec primairede la greffe rénale.Méthodologie : Nous avons évalué l’impact d’une néphrectomiedu greffon (groupe I) et du sevrage de l’immunosuppression (groupeII) sur le taux d’immunisation (PRA pour panel reactive antibody) àdifférents points dans le temps après l’échec de la greffe chez 132patients; le suivi médian était de 47 mois. Sur les 132 patients, 68% ont subi une néphrectomie du greffon, tandis que 32 % ont étéplacés sur la liste d’attente, et on a soit mis fin à leur traitementd’immunosuppression, soit poursuivi leur traitement par prednisoneou par un agent immunosuppresseur à faible dose.Résultats : Lorsque les groupes ont été stratifiés en fonction del’échec précoce (< 6 mois) et tardif (> 6 mois) de la greffe, lespatients qui ont subi une néphrectomie du greffon en raison d’unéchec précoce ont montré une baisse du PRA, passant de 46 %au moment de l’échec de la greffe à 27 % lors du dernier suivi(p = 0,02); en revanche, le PRA a continué d’augmenter chez lespatients du groupe II qui ont présenté un échec précoce de la greffe.Dans les deux groupes, les patients ayant présenté un échec tardifde la greffe présentaient toujours un PRA élevé lors du dernier suivi.Conclusion : La néphrectomie du greffon peut contribuer à limiterl’allosensibilisation dans les cas d’échec précoce de la greffe, maispas dans les cas d’échec tardif.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".