diff --git a/Images/Chronic renal disease prevalence.pdf b/Images/Chronic renal disease prevalence.pdf new file mode 100644 index 0000000..e85b58a Binary files /dev/null and b/Images/Chronic renal disease prevalence.pdf differ diff --git a/Images/Chronic renal disease prevalence.png b/Images/Chronic renal disease prevalence.png new file mode 100644 index 0000000..b99c729 Binary files /dev/null and b/Images/Chronic renal disease prevalence.png differ diff --git a/Images/analyse.png b/Images/analyse.png new file mode 100644 index 0000000..2348ddf Binary files /dev/null and b/Images/analyse.png differ diff --git a/Images/km_global.pdf b/Images/km_global.pdf new file mode 100644 index 0000000..1b1ffe7 Binary files /dev/null and b/Images/km_global.pdf differ diff --git a/Images/km_global.png b/Images/km_global.png new file mode 100644 index 0000000..07b476c Binary files /dev/null and b/Images/km_global.png differ diff --git a/Images/logband.png b/Images/logband.png new file mode 100644 index 0000000..2c9f2a3 Binary files /dev/null and b/Images/logband.png differ diff --git a/LICENSE.md b/LICENSE.md new file mode 100644 index 0000000..d4582d2 --- /dev/null +++ b/LICENSE.md @@ -0,0 +1,22 @@ +The MIT License (MIT) +===================== + +**Copyright (c) 2018-2022 Anish Athalye (me@anishathalye.com)** + +Permission is hereby granted, free of charge, to any person obtaining a copy of +this software and associated documentation files (the "Software"), to deal in +the Software without restriction, including without limitation the rights to +use, copy, modify, merge, publish, distribute, sublicense, and/or sell copies +of the Software, and to permit persons to whom the Software is furnished to do +so, subject to the following conditions: + +The above copyright notice and this permission notice shall be included in all +copies or substantial portions of the Software. + +THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND, EXPRESS OR +IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY, +FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT. IN NO EVENT SHALL THE +AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES OR OTHER +LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT OR OTHERWISE, ARISING FROM, +OUT OF OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN THE +SOFTWARE. diff --git a/Makefile b/Makefile new file mode 100644 index 0000000..34349bf --- /dev/null +++ b/Makefile @@ -0,0 +1,9 @@ +.PHONY: main clean FORCE + +main: poster.pdf + +poster.pdf: FORCE + latexmk -pdflatex='lualatex -interaction nonstopmode' -pdf poster.tex + +clean: + latexmk -pdf -C diff --git a/beamercolorthemenott.sty b/beamercolorthemenott.sty new file mode 100644 index 0000000..71910f9 --- /dev/null +++ b/beamercolorthemenott.sty @@ -0,0 +1,55 @@ +% Gemini theme +% https://github.com/anishathalye/gemini + +% ==================== +% Definitions +% ==================== + +% Colors from https://www.cam.ac.uk/brand-resources/guidelines/typography-and-colour/rgb-and-hex-references +\definecolor{nottblue}{HTML}{99332d} + +% 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b/logos/sphere.pdf differ diff --git a/logos/transp.png b/logos/transp.png new file mode 100644 index 0000000..37dec53 Binary files /dev/null and b/logos/transp.png differ diff --git a/poster.bib b/poster.bib new file mode 100644 index 0000000..80421e7 --- /dev/null +++ b/poster.bib @@ -0,0 +1,68 @@ +@article{metzger2003expanded, + title={Expanded criteria donors for kidney transplantation}, + author={Metzger, Robert A and Delmonico, Francis L and Feng, Sandy and Port, Friedrich K and Wynn, James J and Merion, Robert M}, + journal={American Journal of Transplantation}, + volume={3}, + pages={114--125}, + year={2003}, + publisher={Blackwell Science Ltd Oxford, UK} +} + +@article{dantan2021covariates, + title={Covariates adjustment questioned conclusions of predictive analyses: an illustration with the Kidney Donor Risk Index}, + author={Dantan, Etienne and Le Borgne, Florent and Giral, Magali and Dion, Angelina and Querard, Anne-H{\'e}l{\`e}ne and Foucher, Yohann}, + journal={Journal of Clinical Epidemiology}, + volume={135}, + pages={103--114}, + year={2021}, + publisher={Elsevier} +} + +@article{rein2015, + title={Rapport Annuel 2015}, + publisher={REIN (Réseau Epidémiologique et Information en Néphrologie)}, + journal={Agence de la Biomédecine}, + year={2015}, + url={https://www.agence-biomedecine.fr/IMG/pdf/rapport_rein_2015.pdf} +} + +@inproceedings{bongard2012estimation, + title={Estimation et caract{\'e}risation de l’insuffisance r{\'e}nale chronique en France}, + author={Bongard, V and Dallongeville, J and Arveiler, D and Ruidavets, J-B and Cottel, D and Wagner, A and Ferri{\`e}res, J}, + booktitle={Annales de Cardiologie et d'Ang{\'e}iologie}, + volume={61}, + number={4}, + pages={239--244}, + year={2012}, + organization={Elsevier} +} + +@article{aubert2019disparities, + title={Disparities in acceptance of deceased donor kidneys between the United States and France and estimated effects of increased US acceptance}, + author={Aubert, Olivier and Reese, Peter P and Audry, Benoit and Bouatou, Yassine and Raynaud, Marc and Viglietti, Denis and Legendre, Christophe and Glotz, Denis and Empana, Jean-Phillipe and Jouven, Xavier and others}, + journal={JAMA internal medicine}, + volume={179}, + number={10}, + pages={1365--1374}, + year={2019}, + publisher={American Medical Association} +} + +@article{has2015, + title={Transplantation Rénale - Accès à la liste d'attente nationale - Recommandation de bonne pratique}, + journal={Haute Autorité de Santé}, + year={2015}, + url={https://www.has-sante.fr/upload/docs/application/pdf/2015-12/rbp_recommandations_greffe_renale_vd_mel.pdf} +} + +@article{rao2009comprehensive, + title={A comprehensive risk quantification score for deceased donor kidneys: the kidney donor risk index}, + author={Rao, Panduranga S and Schaubel, Douglas E and Guidinger, Mary K and Andreoni, Kenneth A and Wolfe, Robert A and Merion, Robert M and Port, Friedrich K and Sung, Randall S}, + journal={Transplantation}, + volume={88}, + number={2}, + pages={231--236}, + year={2009}, + publisher={LWW} +} + diff --git a/poster.tex b/poster.tex new file mode 100644 index 0000000..8cd4deb --- /dev/null +++ b/poster.tex @@ -0,0 +1,256 @@ +% Unofficial University of Cambridge Poster Template +% https://github.com/andiac/gemini-cam +% a fork of https://github.com/anishathalye/gemini +% also refer to https://github.com/k4rtik/uchicago-poster + +\documentclass[final]{beamer} + +% ==================== +% Packages +% ==================== + +\usepackage[T1]{fontenc} +\usepackage{lmodern} +\usepackage[orientation=portrait,size=a0,scale=1.0]{beamerposter} +\usetheme{gemini} +\usecolortheme{nott} +\usepackage{graphicx} +\usepackage{booktabs} +\usepackage{tikz} +\usepackage{pgfplots} +\pgfplotsset{compat=1.14} +\usepackage{anyfontsize} +\usepackage{ragged2e} +\let\olditem\item +\renewcommand\item{\olditem\justifying} + +% ==================== +% Lengths +% ==================== +\bibliographystyle{unsrt} +% If you have N columns, choose \sepwidth and \colwidth such that +% (N+1)*\sepwidth + N*\colwidth = \paperwidth +\newlength{\sepwidth} +\newlength{\colwidth} +\setlength{\sepwidth}{0.025\paperwidth} +\setlength{\colwidth}{0.45\paperwidth} + +\newcommand{\separatorcolumn}{\begin{column}{\sepwidth}\end{column}} +\setbeamertemplate{itemize/enumerate subbody begin}{\large} +\setbeamertemplate{itemize/enumerate subsubbody begin}{\large} +% ==================== +% Title +% ==================== + +\title{Development and Validation of a french kidney donor marginality score} + +\author{Corentin Choisy \inst{1} \and Magali Giral \inst{2,3} \and Etienne Dantan \inst{1}} + +\institute[shortinst]{\inst{1} SPHERE UMR 1246, Nantes Université, Univ Tours, CHU Nantes, Inserm, Nantes, France \and \inst{2} CR2TI UMR 1064, Nantes Université, ITUN, CHU Nantes, RTRS Centaure, Nantes, France \and \inst{3} Centre d'Investigation Clinique en Biothérapie, Nantes, France} + +% ==================== +% Footer (optional) +% ==================== + +\footercontent{ + \href{https://www.divat.fr/}{https://www.sphere-inserm.fr/} \hfill + Congrès Nan'thèse 2023, Nantes --- France \hfill + \href{mailto:corentin.choisy@univ-nantes.fr}{corentin.choisy@univ-nantes.fr}} +% (can be left out to remove footer) + +\newcommand{\myitem}{\item[--]} + +% ==================== +% Logo (optional) +% ==================== + +% use this to include logos on the left and/or right side of the header: +\logoright{\includegraphics[height=2em]{logos/transp.png}} +\logoleft{\includegraphics[height=2em]{logos/transp.png}} + +% ==================== +% Body +% ==================== + +\begin{document} + +% Refer to https://github.com/k4rtik/uchicago-poster +% logo: https://www.cam.ac.uk/brand-resources/about-the-logo/logo-downloads +% \addtobeamertemplate{headline}{} +% { +% \begin{tikzpicture}[remember picture,overlay] +% \node [anchor=north west, inner sep=3cm] at ([xshift=-2.5cm,yshift=1.75cm]current page.north west) +% {\includegraphics[height=7cm]{logos/unott-logo.eps}}; +% \end{tikzpicture} +% } + +\begin{frame}[t] +\begin{columns}[t] +\separatorcolumn + +\begin{column}{\colwidth} + + \begin{block}{Background} + + \begin{itemize} + \item \textbf{Kidney transplantation (KT)}: recognised as the best treatment for \textbf{end-stage chronic renal disease} + \begin{itemize} + \setlength{\itemindent}{1em} + \item \textbf{Graft shortage} in countries with aging population + + \textbf{\textcolor{nottblue}{$\Rightarrow$ Necessity for expansion of graft pool}} + \end{itemize} + \item Wide use of \textbf{marginal grafts} with suboptimal properties for patient-graft survival + \item Decision making tools to assist clinicians in evaluating graft proposals + \begin{itemize} + \setlength{\itemindent}{1em} + \item \textbf{ECD \cite{metzger2003expanded}} Older than 60 years old or between 50 and 59 with at least 2 comorbidities among: high serum creatinine, history of hypertension and death by CVA + + \textbf{\textcolor{nottblue}{$\Rightarrow$ Binary criterion, no gradient between less and more marginal donors}} + \item \textbf{KDRI/KDPI \cite{rao2009comprehensive}} Continuous/percentile scale defined by 10 donor features + + \textbf{\textcolor{nottblue}{$\Rightarrow$ Not adapted to the french population \cite{dantan2021covariates} and prone to increased graft refusal rate \cite{aubert2019disparities}}} + + \end{itemize} + \end{itemize} + +\vskip-0.5em + +{\centering\includegraphics[scale=1.6]{Images/Chronic renal disease prevalence.pdf}\par} + +\vskip-1em + + \end{block} + + + + + \begin{block}{Objectives} + + Develop and validate a \textbf{\textcolor{nottblue}{kidney donor marginality score}}, \textbf{adapted to the french population} and \textbf{suited for the current practices} in KT in France + + \begin{itemize} + \item \textbf{Donor/recipient interactions} will be studied in order to express donor marginality in relation to recipient characteristics + \item \textcolor{darkgray}{\textbf{Recipient loss-of-chance} related to receiving a marginal graft as defined by the proposed score will be studied} + \end{itemize} + + \end{block} + +\begin{alertblock}{Materials and Methods} + \begin{itemize} + \item \textbf{7622 patients} from the DIVAT national kidney transplant cohort + \item First-time deceased donor graft recipients without donor-recipient ABO incompatibility + \item \textbf{Multivariate Cox regression} model built via blockwise variable selection approach (Donor/Graft/Recipient features integrated/removed from the model in 11 steps) + \item Assessment of \textbf{period/center effect} via adjusted and frailty models + \item New variable selection steps after integration of period/center effects + \end{itemize} + {\centering\includegraphics[scale=0.36]{Images/analyse.png}\par} + {\centering\small \textbf{Variable selection process} (square nodes indicate all previously included predictors were forced in the model during backward selection, circle nodes indicate no variable was forced)\par} + + + + \end{alertblock} + +\begin{block}{Funding} +\centering + This work was supported by the French Biomedicine Agency (reference: AOR Greffe 2022) +\end{block} + + +\vskip-0.15em + \begin{block}{} + {\centering\includegraphics[scale=0.8]{logos/logband.png}\par} + \end{block} + +\end{column} + +\separatorcolumn + +\begin{column}{\colwidth} + + \begin{block}{Results} + +\vskip-1em + +\begin{figure} + \centering + \includegraphics[scale=1.5]{Images/km_global.pdf} + \vskip-1.25em + \caption{Patient/allograft survival analysis} + \label{fig:km} +\end{figure} + + + +\begin{table}[] +\centering +\begin{tabular}{@{}lcccc@{}} +\toprule + & \beta & 95\% CI \\ \midrule +Donor age & -0.020 & {[-0.037}-- {-0.003]} \\ +Donor after cardiac death & 0.691 & {[0.416}--{0.967]} \\ +Donor death by CVA & -0.616 & {[-1.224}-- {-0.008]} \\ +Donor serum creatinine & 0.001 & {[0.0001}--{0.002]} \\ +Donor height & -0.011 & {[-0.018}-- {-0.004]} \\ +Donor weight & 0.005 & {[0.001}--{0.010]} \\ +Positive donor CMV serology & 0.124 & {[0.010}--{0.239]} \\ +\addlinespace\addlinespace +\textcolor{darkgray}{\textbf{HLA incompatibilities \geq 4}} & 0.151 & {[0.009}--{0.293]} \\ +Time on dialysis & 0.0001 & {[0.0001}--{0.0001]} \\ +Transplanted before 2012 & 0.190 & {[0.040}--{0.340]} \\ +\addlinespace\addlinespace +Recipient age & -0.021 & {[-0.036}-- {-0.005]} \\ +Recipient BMI & 0.011 & {[-0.003}--{0.025]} \\ +Recipient history of diabetes & 0.376 & {[0.234}--{0.517]} \\ +Recipient history of cardiovascular disease & 0.408 & {[0.239}--{0.527]} \\ +Hemodialysis & 0.250 & {[0.048}--{0.452]} \\ +\textcolor{darkgray}{\textbf{Donor age*Recipient age}} & 0.001 & {[0.0001}--{0.001]} \\ +\textcolor{darkgray}{\textbf{Donor death by CVA*Recipient age}} & 0.014 & {[0.003}--{0.024]} \\ \bottomrule +\end{tabular} +\caption{\label{mod-table}Proportional hazards Cox model analysis of retained factors and interactions after multivariate selection} +\end{table} + +\vskip-1em + +\begin{itemize} + \item Donor age, beating heart status ($HR=2.00$), cause of death, creatininemia, height, weight and CMV serology ($HR=1.13$) will be integrated into the score. For a given donor, the score will differ depending on recipient age and donor/recipient HLA ABDR incompatibilities. +\end{itemize} + + \end{block} + +\vskip-0.5em + + \begin{exampleblock}{What's next} + \vskip0.3em + \begin{itemize} + \item \textbf{Internal validation} of the model, $\frac{1}{3}$ of the database allocated to a random validation sample + + \item \textbf{Validity assessed through:} + \begin{itemize} + \setlength{\itemindent}{1em} + \item \textbf{Calibration:} calibration plot, predicted survival by score quantile, Brier score + \item \textbf{Discrimination:} time-dependent ROC curve (AUC, PPV/NPV) and time-dependent ROC curve per recipient strata + \end{itemize} + \item \textbf{Propensity score}-based analysis to estimate population-averaged effects and propose a recipient loss-of-chance-based approach + \item Development of an \textbf{online score computation tool} for clinicians + \end{itemize} + + \end{exampleblock} + + \vskip-1em + + \begin{block}{References} + \vskip-0.15em + \nocite{*} + \footnotesize{\bibliographystyle{plain}\bibliography{poster}} + + \end{block} + + +\end{column} +\separatorcolumn + +\end{columns} +\end{frame} + +\end{document}