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Performance and Advancement of the Kidney Solid Organ Response Test
Joshua Lee1, Mariel Barbachan E Silva2, Yi Bao3
1Immucor Inc, Norcross, GA.
Transplantation
|June 16, 2023
Summary
The kidney solid organ response test (kSORT) shows potential for predicting kidney transplant rejection. Further refinement of the kSORT assay and its prediction algorithm is needed for improved accuracy.
Area of Science:
- Nephrology
- Transplant Immunology
- Molecular Diagnostics
Background:
- Conflicting results exist regarding the kidney solid organ response test (kSORT) for predicting acute rejection in kidney transplant recipients.
- The kSORT assay's association with rejection or immune quiescence requires further investigation.
Purpose of the Study:
- To investigate the association between the kSORT assay score and rejection or immune quiescence in kidney transplant recipients.
- To optimize the predictive cutoff value of the kSORT score for rejection.
Main Methods:
- Blinded analysis of kSORT scores against rejection status.
- Optimization of kSORT prediction cutoff after unblinding.
- Assessment of kSORT gene set predictive capability using microarray and qPCR data.
Main Results:
- The kSORT assay showed an area under the curve of 0.71 for rejection detection.
- Using a kSORT score > 5 yielded a positive predictive value (PPV) of 57.89% and a negative predictive value (NPV) of 78.95%.
- Microarray data improved prediction accuracy (PPV 53%, NPV 84%) compared to qPCR (PPV 36%, NPV 66%).
Conclusions:
- The kSORT assay demonstrates potential as a predictive tool for active rejection and immune quiescence post-kidney transplant.
- Further studies are necessary to enhance and refine the kSORT assay, particularly its prediction algorithm.
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