Evidence map›Paper›PMID 40046053›Full record

ArticleFrontiers in immunology2025

Systemic inflammation is an important risk factor and predictor of graft loss and mortality one year after kidney transplantation.

Torbjørn F Heldal, Anders Åsberg, Thor Ueland, Anna V Reisæter, Søren E Pischke, Tom E Mollnes, Pål Aukrust, Finn P Reinholt, Anders Hartmann, Kristian Heldal and 1 more

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Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Torbjørn F HeldalDepartment of Internal Medicine, Telemark Hospital Trust, Skien, Norway.
Anders ÅsbergDepartment of Transplantation Medicine, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
Thor UelandInstitute of Clinical Medicine, University of Oslo, Oslo, Norway.
Anna V ReisæterDepartment of Transplantation Medicine, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
Søren E PischkeDepartment of Immunology, University of Oslo and Oslo University Hospital, Oslo, Norway.
Tom E MollnesDepartment of Immunology, University of Oslo and Oslo University Hospital, Oslo, Norway.
Pål AukrustInstitute of Clinical Medicine, University of Oslo, Oslo, Norway.
Finn P ReinholtDepartment of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Anders HartmannInstitute of Clinical Medicine, University of Oslo, Oslo, Norway.
Kristian HeldalDepartment of Internal Medicine, Telemark Hospital Trust, Skien, Norway.
Trond G JenssenInstitute of Clinical Medicine, University of Oslo, Oslo, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: An inflammatory environment following kidney transplantation is associated with increased risk of graft loss and mortality, however, evaluation of systemic inflammation is not implemented in structured risk assessment in kidney transplant recipients. Long-term results after transplantation are not satisfactory, and thus tools addressing these issues are needed. In this study, we tested the associations and predictive abilities of a predefined systemic inflammation score one year after transplantation on death-censored graft loss and mortality. Methods: We included 805 patients who underwent kidney transplantation between 2013 and 2017 at the Oslo University Hospital, Rikshospitalet. The inflammation score included five specifically selected biomarkers known to reflect various inflammatory pathways and to be associated with adverse outcomes following transplantation. The score was assessed in relation to outcomes in models with established risk factors. Discriminatory analyses were performed using Harrell´s C-statistic, and model assessment were evaluated using internal validation, calibration, and likelihood ratio tests. Results: The median follow-up time was 6.4 years. There were 168 deaths (20.9%) and 42 graft losses (5.2%). The inflammation score one year after transplantation was significantly associated with graft loss (P<0.001) and mortality (P<0.001). The diagnostic performance of the model for graft loss revealed a c-statistic of 0.77 both with and without histological data. The diagnostic performance for mortality displayed a c-statistic of 0.79. In all tested scenarios, the model fit significantly improved after including the inflammation score. Conclusions: These results suggest a strong association between systemic inflammation one year after transplantation and both graft loss and mortality. Predictive models including the inflammation score and established risk factors were particularly informative when considering mortality. Evaluation of systemic inflammation using this score could be an important tool for risk-assessment after transplantation.

Indexed as

Graft RejectionGraft SurvivalInflammationKidney TransplantationAdultAgedBiomarkersFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRisk AssessmentRisk FactorsBiomarkersbiomarkersgraft lossinflammationkidney transplantationmortalityprediction

Identifiers

PMID40046053
PMCPMC11879994

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