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  1. Article: Automating kidney transplant rejection diagnosis: a simple solution for a complex problem?

    Van Loon, Elisabet / Callemeyn, Jasper / Roufosse, Candice

    Clinical kidney journal

    2023  Volume 16, Issue 11, Page(s) 1720–1722

    Language English
    Publishing date 2023-08-08
    Publishing country England
    Document type News
    ZDB-ID 2655800-2
    ISSN 2048-8513 ; 2048-8505
    ISSN (online) 2048-8513
    ISSN 2048-8505
    DOI 10.1093/ckj/sfad185
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    Zs.A 6587: Show issues Location:
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  2. Article ; Online: Biopsy-based transcriptomics in the diagnosis of kidney transplant rejection.

    de Nattes, Tristan / Beadle, Jack / Roufosse, Candice

    Current opinion in nephrology and hypertension

    2024  Volume 33, Issue 3, Page(s) 273–282

    Abstract: Purpose of review: The last year has seen considerable progress in translational research exploring the clinical utility of biopsy-based transcriptomics of kidney transplant biopsies to enhance the diagnosis of rejection. This review will summarize ... ...

    Abstract Purpose of review: The last year has seen considerable progress in translational research exploring the clinical utility of biopsy-based transcriptomics of kidney transplant biopsies to enhance the diagnosis of rejection. This review will summarize recent findings with a focus on different platforms, potential clinical applications, and barriers to clinical adoption.
    Recent findings: Recent literature has focussed on using biopsy-based transcriptomics to improve diagnosis of rejection, in particular antibody-mediated rejection. Different techniques of gene expression analysis (reverse transcriptase quantitative PCR, microarrays, probe-based techniques) have been used either on separate samples with ideally preserved RNA, or on left over tissue from routine biopsy processing. Despite remarkable consistency in overall patterns of gene expression, there is no consensus on acceptable indications, or whether biopsy-based transcriptomics adds significant value at reasonable cost to current diagnostic practice.
    Summary: Access to biopsy-based transcriptomics will widen as regulatory approvals for platforms and gene expression models develop. Clinicians need more evidence and guidance to inform decisions on how to use precious biopsy samples for biopsy-based transcriptomics, and how to integrate results with standard histology-based diagnosis.
    MeSH term(s) Humans ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods ; Biopsy ; Kidney Diseases/pathology ; Gene Expression Profiling ; Graft Rejection/diagnosis ; Graft Rejection/genetics ; Kidney/pathology
    Language English
    Publishing date 2024-02-21
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000974
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    Zs.A 3686: Show issues Location:
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  3. Article ; Online: Tocilizumab (anti-IL-6) treatment for AA renal amyloidosis in a patient with advanced chronic kidney disease, a case report.

    Seneschall, Charlotte / Law, Steven / Roufosse, Candice / Woodham, Sarah / Kousios, Andreas

    Journal of nephrology

    2024  

    Abstract: Systemic amyloid A amyloidosis is a progressive condition in which sustained elevation of serum amyloid A protein concentration leads to widespread amyloid deposition resulting in multiorgan failure without treatment. The kidney is the most commonly ... ...

    Abstract Systemic amyloid A amyloidosis is a progressive condition in which sustained elevation of serum amyloid A protein concentration leads to widespread amyloid deposition resulting in multiorgan failure without treatment. The kidney is the most commonly affected organ, and renal amyloid A amyloidosis can cause nephrotic syndrome and chronic kidney disease (CKD) leading to end stage kidney disease (ESKD). Serum Amyloid A protein is produced in the liver in response to chronic inflammation, specifically by inflammatory cytokines, especially IL-6. Tocilizumab, a monoclonal antibody that targets the interleukin-6 receptor, has increasingly been of interest in treating amyloid A amyloidosis. We present a case of a 79-year-old male with long-term seronegative polyarthritis who was referred with gradual decline in kidney function and nephrotic range proteinuria. His renal biopsy showed amyloid A amyloidosis with significant interstitial fibrosis and tubular atrophy. He was commenced on monthly tocilizumab infusions and peritoneal dialysis with good clinical response and rapid resolution of his nephrotic state. This case adds to the current literature on the benefits of tocilizumab in treating amyloid A amyloidosis in patients with advanced CKD.
    Language English
    Publishing date 2024-01-11
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 1093991-x
    ISSN 1724-6059 ; 1120-3625 ; 1121-8428
    ISSN (online) 1724-6059
    ISSN 1120-3625 ; 1121-8428
    DOI 10.1007/s40620-023-01845-z
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    Zs.A 3369: Show issues Location:
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  4. Article ; Online: Forging the tools for a computer-aided workflow in transplant pathology.

    Arthurs, Callum / Roufosse, Candice

    The Lancet. Digital health

    2021  Volume 4, Issue 1, Page(s) e2–e3

    MeSH term(s) Computer-Aided Design ; Computers ; Workflow
    Language English
    Publishing date 2021-11-15
    Publishing country England
    Document type Journal Article ; Comment
    ISSN 2589-7500
    ISSN (online) 2589-7500
    DOI 10.1016/S2589-7500(21)00254-5
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  5. Article ; Online: Biopsy-proven fungal pyelonephritis complicating delayed graft function in a renal transplant patient.

    Jesuthasan, Aaron / Roufosse, Candice / Ramaswami, Arun

    BMJ case reports

    2023  Volume 16, Issue 2

    Abstract: Delayed graft function (DGF) is a common phenomenon following renal transplantation, which can be due to several factors. A rare cause includes invasive fungal infections, which can often be a challenge to diagnose. Nonetheless, prompt identification of ... ...

    Abstract Delayed graft function (DGF) is a common phenomenon following renal transplantation, which can be due to several factors. A rare cause includes invasive fungal infections, which can often be a challenge to diagnose. Nonetheless, prompt identification of such infections particularly within transplant patients is essential as they can lead to severe downstream sequelae, including graft loss and even death. We describe here a challenging case of fungal pyelonephritis complicating and potentially leading to DGF and further dialysis dependence within a renal transplant patient. Notably, we highlight the importance and clinical utility of biopsy to confirm the diagnosis, as investigations may be largely normal otherwise. Furthermore, we emphasise that with early identification of these infections, effective antifungal treatment can be commenced in a timely fashion leading to better patient outcomes and good graft function.
    MeSH term(s) Humans ; Kidney Transplantation/adverse effects ; Delayed Graft Function/diagnosis ; Graft Survival ; Renal Dialysis/adverse effects ; Pyelonephritis/diagnosis ; Pyelonephritis/drug therapy ; Pyelonephritis/complications ; Biopsy/adverse effects ; Graft Rejection/diagnosis ; Risk Factors ; Retrospective Studies
    Language English
    Publishing date 2023-02-10
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2022-252313
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  6. Article ; Online: Steroid Sparing Maintenance Immunosuppression in Highly Sensitised Patients Receiving Alemtuzumab Induction.

    Santos, Eva / Spensley, Katrina / Gunby, Nicola / Clarke, Candice / Anand, Arthi / Roufosse, Candice / Willicombe, Michelle

    Transplant international : official journal of the European Society for Organ Transplantation

    2023  Volume 36, Page(s) 11056

    Abstract: This analysis reports on the outcomes of two different steroid sparing immunosuppression protocols used in the management of 120 highly sensitised patients (HSPs) with cRF>85% receiving Alemtuzumab induction, 53 maintained on tacrolimus (FK) monotherapy ... ...

    Abstract This analysis reports on the outcomes of two different steroid sparing immunosuppression protocols used in the management of 120 highly sensitised patients (HSPs) with cRF>85% receiving Alemtuzumab induction, 53 maintained on tacrolimus (FK) monotherapy and 67 tacrolimus plus mycophenolate mofetil (FK + MMF). There was no difference in the median cRF or mode of sensitisation between the two groups, although the FK + MMF cohort received more poorly matched grafts. There was no difference in one-year patient or allograft survival, however rejection free survival was inferior with FK monotherapy compared with FK + MMF at 65.4% and 91.4% respectively,
    MeSH term(s) Humans ; Alemtuzumab/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Tacrolimus/therapeutic use ; Kidney Transplantation/methods ; Immunosuppression Therapy/methods ; Steroids ; Mycophenolic Acid/therapeutic use ; Graft Rejection/prevention & control ; Graft Survival
    Chemical Substances Alemtuzumab (3A189DH42V) ; Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM) ; Steroids ; Mycophenolic Acid (HU9DX48N0T)
    Language English
    Publishing date 2023-06-02
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 639435-8
    ISSN 1432-2277 ; 0934-0874
    ISSN (online) 1432-2277
    ISSN 0934-0874
    DOI 10.3389/ti.2023.11056
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    Zs.A 2358: Show issues Location:
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  7. Article ; Online: Application of HLA molecular level mismatching in ethnically diverse kidney transplant recipients receiving a steroid-sparing immunosuppression protocol.

    Santos, Eva / Spensley, Katrina / Gunby, Nicola / Worthington, Judith / Roufosse, Candice / Anand, Arthi / Willicombe, Michelle

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2024  

    Abstract: Defining HLA mismatch at the molecular compared with the antigen level has been shown to be superior in predicting alloimmune responses, although data from across different patient populations are lacking. Using HLA-Matchmaker, HLA-EMMA and PIRCHE-II, ... ...

    Abstract Defining HLA mismatch at the molecular compared with the antigen level has been shown to be superior in predicting alloimmune responses, although data from across different patient populations are lacking. Using HLA-Matchmaker, HLA-EMMA and PIRCHE-II, this study reports on the association between molecular mismatch (MolMM) and de novo donor-specific antibody (dnDSA) in an ethnically diverse kidney transplant population receiving a steroid-sparing immunosuppression protocol. Of the 419 patients, 51 (12.2%) patients had dnDSA. De novo DSA were seen more frequently with males, primary transplants, patients receiving tacrolimus monotherapy, and unfavorably HLA-matched transplants. There was a strong correlation between MolMM load and antigen mismatch, although significant variation of MolMM load existed at each antigen mismatch. MolMM loads differed significantly by recipient ethnicity, although ethnicity alone was not associated with dnDSA. On multivariate analysis, increasing MolMM loads associated with dnDSA, whereas antigen mismatch did not. De novo DSA against 8 specific epitopes occurred at high frequency; of the 51 patients, 47 (92.1%) patients with dnDSA underwent a pretreatment biopsy, with 21 (44.7%) having evidence of alloimmune injury. MolMM has higher specificity than antigen mismatching at identifying recipients who are at low risk of dnDSA while receiving minimalist immunosuppression. Immunogenicity consideration is important, with more work needed on identification, especially across different ethnic groups.
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1016/j.ajt.2024.02.019
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    Zs.A 5542: Show issues Location:
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  8. Article ; Online: Diffuse crescentic glomerulonephritis presenting with preserved renal function.

    Gulati, Kavita / Roufosse, Candice / McAdoo, Stephen P

    Rheumatology (Oxford, England)

    2021  Volume 60, Issue Suppl 3, Page(s) iii18–iii20

    MeSH term(s) Antibodies, Antineutrophil Cytoplasmic/blood ; Glomerulonephritis/blood ; Glomerulonephritis/diagnosis ; Glomerulonephritis/drug therapy ; Glomerulonephritis/pathology ; Humans ; Immunosuppressive Agents/therapeutic use ; Kidney/pathology ; Kidney Function Tests ; Male ; Young Adult
    Chemical Substances Antibodies, Antineutrophil Cytoplasmic ; Immunosuppressive Agents
    Language English
    Publishing date 2021-06-17
    Publishing country England
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/keab105
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  9. Article ; Online: The expanding spectrum of antibody-mediated rejection: Should we include cases where no anti-HLA donor-specific antibody is detected?

    Randhawa, Parmjeet / Roufosse, Candice

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2018  Volume 19, Issue 3, Page(s) 622–624

    MeSH term(s) Antilymphocyte Serum ; Graft Rejection
    Chemical Substances Antilymphocyte Serum
    Language English
    Publishing date 2018-10-01
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.15114
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  10. Book ; Online: Realistic Data Enrichment for Robust Image Segmentation in Histopathology

    Cechnicka, Sarah / Ball, James / Arthurs, Callum / Roufosse, Candice / Kainz, Bernhard

    2023  

    Abstract: Poor performance of quantitative analysis in histopathological Whole Slide Images (WSI) has been a significant obstacle in clinical practice. Annotating large-scale WSIs manually is a demanding and time-consuming task, unlikely to yield the expected ... ...

    Abstract Poor performance of quantitative analysis in histopathological Whole Slide Images (WSI) has been a significant obstacle in clinical practice. Annotating large-scale WSIs manually is a demanding and time-consuming task, unlikely to yield the expected results when used for fully supervised learning systems. Rarely observed disease patterns and large differences in object scales are difficult to model through conventional patient intake. Prior methods either fall back to direct disease classification, which only requires learning a few factors per image, or report on average image segmentation performance, which is highly biased towards majority observations. Geometric image augmentation is commonly used to improve robustness for average case predictions and to enrich limited datasets. So far no method provided sampling of a realistic posterior distribution to improve stability, e.g. for the segmentation of imbalanced objects within images. Therefore, we propose a new approach, based on diffusion models, which can enrich an imbalanced dataset with plausible examples from underrepresented groups by conditioning on segmentation maps. Our method can simply expand limited clinical datasets making them suitable to train machine learning pipelines, and provides an interpretable and human-controllable way of generating histopathology images that are indistinguishable from real ones to human experts. We validate our findings on two datasets, one from the public domain and one from a Kidney Transplant study.

    Comment: 11 pages, 2 figures, 1 table
    Keywords Computer Science - Computer Vision and Pattern Recognition
    Subject code 006
    Publishing date 2023-04-19
    Publishing country us
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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