Granulocyte colony‐stimulating factor with or without immunosuppression reduction in neutropenic kidney transplant recipients
Bibliographic record
Abstract
Abstract Introduction Neutropenia post‐kidney transplantation is associated with adverse graft and patient outcomes. We aimed to analyze the effect of granulocyte colony‐stimulating factor (G‐CSF) use with and without immunosuppression reduction on graft outcomes in neutropenic recipients. Methods In this retrospective cohort study, we identified 120 recipients with neutropenia, within the first‐year post‐transplant. Results Of these, 45.0% underwent no intervention, 17.5% had immunosuppression reduced, 18.3% were only given G‐CSF, and 19.2% had both interventions. Overall, 61 patients experienced the composite outcome of de‐novo DSA, biopsy‐proven acute rejection, and all‐cause graft failure and the cumulative incidence of this outcome did not vary by any of the four interventions ( p = .93). When stratifying the cohort by G‐CSF use alone, those who received G‐CSF were more likely to have had severe neutropenia (<500/mm 3 : 51.1% vs. 12.0%, p < .001), and immunosuppression reduction (51.1% vs. 28.0%, p = .003). However, the composite outcome was not different in the G‐CSF and no G‐CSF cohort (53.3% vs. 49.3%, p = .67), and in a multivariate model, G‐CSF use was not associated with this outcome (aHR = 1.18, 95% CI: .61–2.30). However, a trend towards higher DSA production was noted in the G‐CSF cohort (87.5% vs. 62.2%) and this observation warrants prospective evaluation. Conclusion Overall, we conclude that G‐CSF use with or without immunosuppression reduction was not associated with graft outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 teacher head, 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".