Evidence map›Paper›PMID 28833936›Full record

ArticlePediatric transplantation2017

Persistent C4d and antibody-mediated rejection in pediatric renal transplant patients.

Andrew M South, Lynn Maestretti, Neeraja Kambham, Paul C Grimm, Abanti Chaudhuri

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric transplantation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Andrew M SouthSection of Nephrology, Department of Pediatrics, Wake Forest School of Medicine, Winston Salem, NC, USA.ORCID http://orcid.org/0000-0002-3204-4142
Lynn MaestrettiPediatric Renal Transplant Program, Lucile Packard Children's Hospital at Stanford, Stanford, CA, USA.
Neeraja KambhamDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Paul C GrimmDivision of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Abanti ChaudhuriDivision of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.

Funding

TRAINING PROGRAM IN ACADEMIC NEPHROLOGYT32DK007357 · NIDDK · STANFORD UNIVERSITY · PI CHERTOW, GLENN MATTHEW · 1986 to 2022
$4.8M
Detection/Dysplastic Epithelium/Gastrointestinal TractR33CA094304 · NCI · UNIVERSITY HOSPITALS OF CLEVELAND · PI SIVAK, MICHAEL V · 2002 to 2004
$1.5M
Spectrum Stanford Center for Clinical and Translational Research and EducationTL1TR001084 · NCATS · STANFORD UNIVERSITY · PI CULLEN, MARK RICHARD, GREENBERG, HARRY BERNARD · 2013 to 2017
$1.1M
NCATS NIH HHS TL1 TR001084NCI NIH HHS R33 CA094304NIDDK NIH HHS T32 DK007357
6 · The paper itself

Abstract

Pediatric renal transplant recipient survival continues to improve, but ABMR remains a significant contributor to graft loss. ABMR prognostic factors to guide treatment are lacking. C4d staining on biopsies, diagnostic of ABMR, is associated with graft failure. Persistent C4d+ on follow-up biopsies has unknown significance, but could be associated with worse outcomes. We evaluated a retrospective cohort of 17 pediatric renal transplant patients diagnosed with ABMR. Primary outcome at 12 months was a composite of ≥50% reduction in eGFR, transplant glomerulopathy, or graft failure. Secondary outcome was the UPCR at 12 months. We used logistic and linear regression modeling to determine whether persistent C4d+ on follow-up biopsy was associated with the outcomes. Forty-one percent reached the primary outcome at 12 months. Persistent C4d+ on follow-up biopsy occurred in 41% and was not significantly associated with the primary outcome, but was significantly associated with the secondary outcome (estimate 0.22, 95% CI 0.19-0.25, P < .001), after controlling for confounding factors. Persistent C4d+ on follow-up biopsies was associated with a higher UPCR at 12 months. Patients who remain C4d+ on follow-up biopsy may benefit from more aggressive or prolonged ABMR treatment.

Indexed as

Kidney TransplantationAdolescentBiomarkersBiopsyChildChild, PreschoolComplement C4bFemaleFollow-Up StudiesGraft RejectionHumansInfantKidneyLinear ModelsLogistic ModelsMaleBiomarkersComplement C4bcomplement C4dPeptide FragmentsC1qdonor-specific antibodygraft failurehumoral rejectionproteinuriatransplant glomerulopathy

Identifiers

PMID28833936
PMCPMC5645786

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.