The current standard for biopsy-based diagnoses of dysfunction of kidney transplants is the Banff Classification which represents arbitrary international consensus. Recent data-driven approaches using molecular and conventional technologies indicate that mere consensus produces frequently incorrect diagnoses with potential harm to patients due to inappropriate treatment. To address this unmet need and improve diagnostics in the area of organ transplantation, the Alberta Transplant Applied Genomics Centre (ATAGC) has developed a new diagnostic system that combines the molecular and histopathological features of transplant biopsies, plus clinical and laboratory parameters, to create the first Integrated Diagnostic System. The present study will validate and refine this system in 500 prospectively unselected biopsies for clinical indications from American, Canadian and European centres in addition to 300 biopsies already collected. Due to a considerable interest and support from participating Centers, the study is further extended to 1500 prospective biopsies. Thus this is the extension of the INTERCOM study (INTERCOMEX). In addition to demonstrating the feasibility and value of this System in routine patient care and clinical trials, the study will develop and optimize a transparent and user-friendly reporting format to communicate this information to clinicians and obtain detailed feedback on how this system can best improve patient care.
The study has enrolled so far 3012 biopsies from 2313 participants and the results are analyzed for these biopsies. Follow-up data is, and will be collected.
Study Type
OBSERVATIONAL
Enrollment
500
University of Alabama
Birmingham, Alabama, United States
COMPLETEDUniversity of Maryland School of Medicine
Baltimore, Maryland, United States
COMPLETEDUniversity of Michigan Health System
Ann Arbor, Michigan, United States
COMPLETEDUniversity of Minnesota
Minneapolis, Minnesota, United States
COMPLETEDValidate the Integrated Diagnostic System in the International Collaborative Microarray (INTERCOM) Study
1. The rejection classifier predicts Banff diagnosis of any rejection: ABMR, TCMR, or mixed ABMR and TCMR; 2. The TCMR classifier predicts the presence of Banff TCMR lesions/diagnoses; 3. The ABMR classifier predicts the presence of ABMR lesions; 4. In late (\>1yr) biopsies for clinical indications, the failure classifier predicts failure within three years.
Time frame: 2013-2016
Demonstrate the feasibility of molecular phenotyping of 300 + 500 kidney transplant biopsies for clinical indications.
To test the hypothesis that the molecular phenotype of a newly acquired sample predicts the histologic and clinical features of this sample.
Time frame: 2014-2016
Demonstrate the feasibility of molecular phenotyping of 500 biopsies in real time i.e. returning the molecular phenotyping report in two working days upon sample arrival.
Refine the reports based on feedback from the participants.
Time frame: 2015-2016
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Barnes-Jewish Hospital
St Louis, Missouri, United States
COMPLETEDMontefiore Medical Center
The Bronx, New York, United States
COMPLETEDPinnacle Transplant Associates
Harrisburg, Pennsylvania, United States
COMPLETEDTexas Transplant Institute - Methodist Healthcare System
San Antonio, Texas, United States
COMPLETEDVirginia Commonwealth University School of Medicine
Richmond, Virginia, United States
COMPLETEDUniversity of Wisconsin School of Medicine and Public Health
Madison, Wisconsin, United States
COMPLETED...and 16 more locations