A large, international study on post-transplant glomerular diseases: The TANGO project

Audrey Uffing, Maria José Pérez-Sáez, Gaetano La Manna, Giorgia Comai, Clara Fischman, Samira Farouk, Roberto Ceratti Manfro, Andrea Carla Bauer, Bruno Lichtenfels, Juliana B. Mansur, Hélio Tedesco-Silva, Gianna M. Kirsztajn, Anna Manonelles, Oriol Bestard, Miguel Carlos Riella, Silvia Regina Hokazono, Carlos Arias-Cabrales, Elias David-Neto, Carlucci Gualberto Ventura, Enver AkalinOmar Mohammed, Eliyahu V. Khankin, Kassem Safa, Paolo Malvezzi, Michelle Marie O'Shaughnessy, Xingxing S. Cheng, Paolo Cravedi, Leonardo V. Riella

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Long-term outcomes in kidney transplantation (KT) have not significantly improved during the past twenty years. Despite being a leading cause of graft failure, glomerular disease (GD) recurrence remains poorly understood, due to heterogeneity in disease pathogenesis and clinical presentation, reliance on histopathology to confirm disease recurrence, and the low incidence of individual GD subtypes. Large, international cohorts of patients with GD are urgently needed to better understand the disease pathophysiology, predictors of recurrence, and response to therapy. Methods: The Post-TrANsplant GlOmerular Disease (TANGO) study is an observational, multicenter cohort study initiated in January 2017 that aims to: 1) characterize the natural history of GD after KT, 2) create a biorepository of saliva, blood, urine, stools and kidney tissue samples, and 3) establish a network of patients and centers to support novel therapeutic trials. The study includes 15 centers in America and Europe. Enrollment is open to patients with biopsy-proven GD prior to transplantation, including IgA nephropathy, membranous nephropathy, focal and segmental glomerulosclerosis, atypical hemolytic uremic syndrome, dense-deposit disease, C3 glomerulopathy, complement- and IgG-positive membranoproliferative glomerulonephritis or membranoproliferative glomerulonephritis type I-III (old classification). During phase 1, patient data will be collected in an online database. The biorepository (phase 2) will involve collection of samples from patients for identification of predictors of recurrence, biomarkers of disease activity or response to therapy, and novel pathogenic mechanisms. Finally, through phase 3, we will use our multicenter network of patients and centers to launch interventional studies. Discussion: Most prior studies of post-transplant GD recurrence are single-center and retrospective, or rely upon registry data that frequently misclassify the cause of kidney disease. Systematically determining GD recurrence rates and predictors of clinical outcomes is essential to improving post-transplant outcomes. Furthermore, accurate molecular phenotyping and biomarker development will allow better understanding of individual GD pathogenesis, and potentially identify novel drug targets for GD in both native and transplanted kidneys. The TANGO study has the potential to tackle GD recurrence through a multicenter design and a comprehensive biorepository.

Original languageEnglish (US)
Article number299
JournalBMC Nephrology
Volume19
Issue number1
DOIs
StatePublished - Sep 12 2018

Fingerprint

Transplants
Membranoproliferative Glomerulonephritis
Recurrence
Kidney Transplantation
Biomarkers
Kidney
Focal Segmental Glomerulosclerosis
Membranous Glomerulonephritis
Complement C3
Kidney Diseases
Natural History
Saliva
Immunoglobulin A
Multicenter Studies
Observational Studies
Registries
Cohort Studies
Therapeutics
Immunoglobulin G
Transplantation

Keywords

  • Database
  • Glomerulonephritis
  • Kidney transplant
  • Recurrence
  • Registry

ASJC Scopus subject areas

  • Nephrology

Cite this

Uffing, A., Pérez-Sáez, M. J., La Manna, G., Comai, G., Fischman, C., Farouk, S., ... Riella, L. V. (2018). A large, international study on post-transplant glomerular diseases: The TANGO project. BMC Nephrology, 19(1), [299]. https://doi.org/10.1186/s12882-018-1025-z

A large, international study on post-transplant glomerular diseases : The TANGO project. / Uffing, Audrey; Pérez-Sáez, Maria José; La Manna, Gaetano; Comai, Giorgia; Fischman, Clara; Farouk, Samira; Manfro, Roberto Ceratti; Bauer, Andrea Carla; Lichtenfels, Bruno; Mansur, Juliana B.; Tedesco-Silva, Hélio; Kirsztajn, Gianna M.; Manonelles, Anna; Bestard, Oriol; Riella, Miguel Carlos; Hokazono, Silvia Regina; Arias-Cabrales, Carlos; David-Neto, Elias; Ventura, Carlucci Gualberto; Akalin, Enver; Mohammed, Omar; Khankin, Eliyahu V.; Safa, Kassem; Malvezzi, Paolo; O'Shaughnessy, Michelle Marie; Cheng, Xingxing S.; Cravedi, Paolo; Riella, Leonardo V.

In: BMC Nephrology, Vol. 19, No. 1, 299, 12.09.2018.

Research output: Contribution to journalArticle

Uffing, A, Pérez-Sáez, MJ, La Manna, G, Comai, G, Fischman, C, Farouk, S, Manfro, RC, Bauer, AC, Lichtenfels, B, Mansur, JB, Tedesco-Silva, H, Kirsztajn, GM, Manonelles, A, Bestard, O, Riella, MC, Hokazono, SR, Arias-Cabrales, C, David-Neto, E, Ventura, CG, Akalin, E, Mohammed, O, Khankin, EV, Safa, K, Malvezzi, P, O'Shaughnessy, MM, Cheng, XS, Cravedi, P & Riella, LV 2018, 'A large, international study on post-transplant glomerular diseases: The TANGO project', BMC Nephrology, vol. 19, no. 1, 299. https://doi.org/10.1186/s12882-018-1025-z
Uffing A, Pérez-Sáez MJ, La Manna G, Comai G, Fischman C, Farouk S et al. A large, international study on post-transplant glomerular diseases: The TANGO project. BMC Nephrology. 2018 Sep 12;19(1). 299. https://doi.org/10.1186/s12882-018-1025-z
Uffing, Audrey ; Pérez-Sáez, Maria José ; La Manna, Gaetano ; Comai, Giorgia ; Fischman, Clara ; Farouk, Samira ; Manfro, Roberto Ceratti ; Bauer, Andrea Carla ; Lichtenfels, Bruno ; Mansur, Juliana B. ; Tedesco-Silva, Hélio ; Kirsztajn, Gianna M. ; Manonelles, Anna ; Bestard, Oriol ; Riella, Miguel Carlos ; Hokazono, Silvia Regina ; Arias-Cabrales, Carlos ; David-Neto, Elias ; Ventura, Carlucci Gualberto ; Akalin, Enver ; Mohammed, Omar ; Khankin, Eliyahu V. ; Safa, Kassem ; Malvezzi, Paolo ; O'Shaughnessy, Michelle Marie ; Cheng, Xingxing S. ; Cravedi, Paolo ; Riella, Leonardo V. / A large, international study on post-transplant glomerular diseases : The TANGO project. In: BMC Nephrology. 2018 ; Vol. 19, No. 1.
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T1 - A large, international study on post-transplant glomerular diseases

T2 - The TANGO project

AU - Uffing, Audrey

AU - Pérez-Sáez, Maria José

AU - La Manna, Gaetano

AU - Comai, Giorgia

AU - Fischman, Clara

AU - Farouk, Samira

AU - Manfro, Roberto Ceratti

AU - Bauer, Andrea Carla

AU - Lichtenfels, Bruno

AU - Mansur, Juliana B.

AU - Tedesco-Silva, Hélio

AU - Kirsztajn, Gianna M.

AU - Manonelles, Anna

AU - Bestard, Oriol

AU - Riella, Miguel Carlos

AU - Hokazono, Silvia Regina

AU - Arias-Cabrales, Carlos

AU - David-Neto, Elias

AU - Ventura, Carlucci Gualberto

AU - Akalin, Enver

AU - Mohammed, Omar

AU - Khankin, Eliyahu V.

AU - Safa, Kassem

AU - Malvezzi, Paolo

AU - O'Shaughnessy, Michelle Marie

AU - Cheng, Xingxing S.

AU - Cravedi, Paolo

AU - Riella, Leonardo V.

PY - 2018/9/12

Y1 - 2018/9/12

N2 - Background: Long-term outcomes in kidney transplantation (KT) have not significantly improved during the past twenty years. Despite being a leading cause of graft failure, glomerular disease (GD) recurrence remains poorly understood, due to heterogeneity in disease pathogenesis and clinical presentation, reliance on histopathology to confirm disease recurrence, and the low incidence of individual GD subtypes. Large, international cohorts of patients with GD are urgently needed to better understand the disease pathophysiology, predictors of recurrence, and response to therapy. Methods: The Post-TrANsplant GlOmerular Disease (TANGO) study is an observational, multicenter cohort study initiated in January 2017 that aims to: 1) characterize the natural history of GD after KT, 2) create a biorepository of saliva, blood, urine, stools and kidney tissue samples, and 3) establish a network of patients and centers to support novel therapeutic trials. The study includes 15 centers in America and Europe. Enrollment is open to patients with biopsy-proven GD prior to transplantation, including IgA nephropathy, membranous nephropathy, focal and segmental glomerulosclerosis, atypical hemolytic uremic syndrome, dense-deposit disease, C3 glomerulopathy, complement- and IgG-positive membranoproliferative glomerulonephritis or membranoproliferative glomerulonephritis type I-III (old classification). During phase 1, patient data will be collected in an online database. The biorepository (phase 2) will involve collection of samples from patients for identification of predictors of recurrence, biomarkers of disease activity or response to therapy, and novel pathogenic mechanisms. Finally, through phase 3, we will use our multicenter network of patients and centers to launch interventional studies. Discussion: Most prior studies of post-transplant GD recurrence are single-center and retrospective, or rely upon registry data that frequently misclassify the cause of kidney disease. Systematically determining GD recurrence rates and predictors of clinical outcomes is essential to improving post-transplant outcomes. Furthermore, accurate molecular phenotyping and biomarker development will allow better understanding of individual GD pathogenesis, and potentially identify novel drug targets for GD in both native and transplanted kidneys. The TANGO study has the potential to tackle GD recurrence through a multicenter design and a comprehensive biorepository.

AB - Background: Long-term outcomes in kidney transplantation (KT) have not significantly improved during the past twenty years. Despite being a leading cause of graft failure, glomerular disease (GD) recurrence remains poorly understood, due to heterogeneity in disease pathogenesis and clinical presentation, reliance on histopathology to confirm disease recurrence, and the low incidence of individual GD subtypes. Large, international cohorts of patients with GD are urgently needed to better understand the disease pathophysiology, predictors of recurrence, and response to therapy. Methods: The Post-TrANsplant GlOmerular Disease (TANGO) study is an observational, multicenter cohort study initiated in January 2017 that aims to: 1) characterize the natural history of GD after KT, 2) create a biorepository of saliva, blood, urine, stools and kidney tissue samples, and 3) establish a network of patients and centers to support novel therapeutic trials. The study includes 15 centers in America and Europe. Enrollment is open to patients with biopsy-proven GD prior to transplantation, including IgA nephropathy, membranous nephropathy, focal and segmental glomerulosclerosis, atypical hemolytic uremic syndrome, dense-deposit disease, C3 glomerulopathy, complement- and IgG-positive membranoproliferative glomerulonephritis or membranoproliferative glomerulonephritis type I-III (old classification). During phase 1, patient data will be collected in an online database. The biorepository (phase 2) will involve collection of samples from patients for identification of predictors of recurrence, biomarkers of disease activity or response to therapy, and novel pathogenic mechanisms. Finally, through phase 3, we will use our multicenter network of patients and centers to launch interventional studies. Discussion: Most prior studies of post-transplant GD recurrence are single-center and retrospective, or rely upon registry data that frequently misclassify the cause of kidney disease. Systematically determining GD recurrence rates and predictors of clinical outcomes is essential to improving post-transplant outcomes. Furthermore, accurate molecular phenotyping and biomarker development will allow better understanding of individual GD pathogenesis, and potentially identify novel drug targets for GD in both native and transplanted kidneys. The TANGO study has the potential to tackle GD recurrence through a multicenter design and a comprehensive biorepository.

KW - Database

KW - Glomerulonephritis

KW - Kidney transplant

KW - Recurrence

KW - Registry

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