What question did this study set out to answer?

To define the diagnostic relationships and correlation network among four standard and molecular tests used to assess kidney transplant antibody-mediated rejection.

June 17, 2025Kidney International ReportsOpen Access

Defining Relationships Among Tests for Kidney Transplant Antibody-Mediated Rejection

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Authors

KMKatelynn S. Madill-ThomsenUniversity of Alberta LHLuis HidalgoUniversity of Wisconsin–Madison ZDZachary DemkoBoston Scientific (United States)

Discussion

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Implication

Clinical trial demonstrates a correlation hierarchy among four rejection tests in kidney recipients, indicating molecular tools enhance diagnostic precision.

Key Points

To define the diagnostic relationships and correlation network among four standard and molecular tests used to assess kidney transplant antibody-mediated rejection.
Analyzed N=717 indication biopsies from the Trifecta-Kidney clinical trial (ClinicalTrials.gov NCT04239703).
Compared standard-of-care histologic diagnosis, Molecular Microscope Diagnostic System (MMDx), donor-derived cell-free DNA (dd-cfDNA), and donor-specific antibodies (DSA) using a partial correlation network.
Evaluated graft outcome predictions against the earlier INTERCOMEX study cohort for confirmation.
A partial correlation hierarchy was established among tests: MMDx ABMR > dd-cfDNA > histology ABMR > DSA, with DSA correlating at least as strongly with MMDx as with histology.
MMDx diagnosed antibody-mediated rejection more frequently than standard histology; when the two modalities conflicted, dd-cfDNA and DSA aligned more strongly with MMDx results.
Molecular rejection predicted kidney graft outcomes superiorly to histologic assessment across the cohort.

Cite This Study

Madill-Thomsen et al. (2025) studied this question.

synapsesocial.com/papers/6a9b45d5e4c99beff7910cb8 https://doi.org/10.1016/j.ekir.2025.06.017

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Implication

Clinical trial demonstrates a correlation hierarchy among four rejection tests in kidney recipients, indicating molecular tools enhance diagnostic precision.

Defining Relationships Among Tests for Kidney Transplant Antibody-Mediated Rejection

Discussion

Member takes

Implication

Key Points

Cite This Study

Defining Relationships Among Tests for Kidney Transplant Antibody-Mediated Rejection

Discussion

Member takes

Implication

Key Points

Cite This Study

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