ArticleNature medicine2023
An automated histological classification system for precision diagnostics of kidney allografts.
Article in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 29 papers.
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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.
The EUropean TRAnsplantation and INnovation Consortium for Risk Stratification in Kidney Transplant Patients
Development, Application, and Validation of a Comprehensive Classification Automation System for Allograft Precision Diagnostics in Adult and Pediatric Kidney Transplant Biopsies
Who cites it
29 citing papers in PubMed, 53 citations in OpenAlex.
- Bortezomib in combination with standard-of-care for late active antibody-mediated rejection with de novo donor-specific antibodies after kidney transplantation: a multicenter randomized trial.Transplant international : official journal of the European Society for Organ Transplantation · 2026Trial
- Artificial intelligence in preclinical nonhuman primate xenotransplantation: bridging the gap from data complexity to clinical precision.Clinical transplantation and research · 2026Review
- Early i-IFTA: Associated factors and impact on graft outcome.Histology and histopathology · 2026Article
- Application of machine learning in the research progress of post-kidney transplant rejection.World journal of transplantation · 2026Review
- Transforming nephrology through artificial intelligence: a state-of-the-art roadmap for clinical integration.Clinical kidney journal · 2026Review
- Article
- From thresholds to trajectories: a perspective on reframing alloimmune risk for computational modeling in solid organ transplantation.Frontiers in immunology · 2026Review
- Editorial: Methods in alloimmunity and transplantation: 2025.Frontiers in immunology · 2026Article
- Continuous indices to assess the phenotypic spectrum of kidney transplant rejection.Nature communications · 2025Article
- Artificial intelligence and systems biology analysis in stem cell research and therapeutics development.Stem cells translational medicine · 2025Review
- Reshaping transplantation with AI, emerging technologies and xenotransplantation.Nature medicine · 2025Review
- Artificial intelligence-enhanced interpretation of kidney transplant biopsy: focus on rejection.Current opinion in organ transplantation · 2025Review
- [Therapeutic response and monitoring of antibody-mediated renal graft rejection].Revista medica del Instituto Mexicano del Seguro Social · 2025Article
- Diagnostic agreement and limitations of the Banff automated system in kidney transplant biopsies.Frontiers in nephrology · 2025Article
- Application of spatial-omics to the classification of kidney biopsy samples in transplantation.Nature reviews. Nephrology · 2024Review
- Systematic Biopsy-Based Transcriptomics and Diagnosis of Antibody-Mediated Kidney Transplant Rejection in Clinical Practice.Clinical journal of the American Society of Nephrology : CJASN · 2024Article
- [Artificial intelligence in kidney transplant pathology].Pathologie (Heidelberg, Germany) · 2024Review
- Dynamic monitoring soft tissue healing via visualized Gd-crosslinked double network MRI microspheres.Journal of nanobiotechnology · 2024Article
- Design, cohort profile and comparison of the KTD-Innov study: a prospective multidimensional biomarker validation study in kidney allograft rejection.European journal of epidemiology · 2024Article
- Utility of Routine Post Kidney Transplant Anti-HLA Antibody Screening.Kidney international reports · 2024Article
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Authors and funding
38 authors at 20 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
For three decades, the international Banff classification has been the gold standard for kidney allograft rejection diagnosis, but this system has become complex over time with the integration of multimodal data and rules, leading to misclassifications that can have deleterious therapeutic consequences for patients. To improve diagnosis, we developed a decision-support system, based on an algorithm covering all classification rules and diagnostic scenarios, that automatically assigns kidney allograft diagnoses. We then tested its ability to reclassify rejection diagnoses for adult and pediatric kidney transplant recipients in three international multicentric cohorts and two large prospective clinical trials, including 4,409 biopsies from 3,054 patients (62.05% male and 37.95% female) followed in 20 transplant referral centers in Europe and North America. In the adult kidney transplant population, the Banff Automation System reclassified 83 out of 279 (29.75%) antibody-mediated rejection cases and 57 out of 105 (54.29%) T cell-mediated rejection cases, whereas 237 out of 3,239 (7.32%) biopsies diagnosed as non-rejection by pathologists were reclassified as rejection. In the pediatric population, the reclassification rates were 8 out of 26 (30.77%) for antibody-mediated rejection and 12 out of 39 (30.77%) for T cell-mediated rejection. Finally, we found that reclassification of the initial diagnoses by the Banff Automation System was associated with an improved risk stratification of long-term allograft outcomes. This study demonstrates the potential of an automated histological classification to improve transplant patient care by correcting diagnostic errors and standardizing allograft rejection diagnoses.ClinicalTrials.gov registration: NCT05306795 .
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Registered trials
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.