Biomarker findings are hard to validate and generalise across centres
Evidence level: proposed bottleneck; synthesis of abstract-level sources; pending approval
Prognostic markers often perform differently between cohorts or centres, and translation into routine diagnostic tests is described as a barrier.
As of . Primary source: A-score centre variability (DOI).
Summary
The cumulative rejection A-score was not associated with graft outcome in a 772-patient primary cohort but was associated with CLAD in a 300-patient comparison cohort, and its authors conclude it is not generalisable across all centres. The lavage CCSP threshold was not confirmed on its own in a 353-patient validation study. The UHN profile of Andrew Sage states that translation of biomarkers into diagnostic tests remains a significant barrier to routine clinical adoption. Oscillometry variability was reported in a small cohort with 29 CLAD cases at onset and was not externally validated in the abstract. These are four separate observations, and the overall pattern is the editorial synthesis of this site.
Details
- barrier type
- validation and translation
Sources and links
Related
Links from this record
- evidence: Center variability in the prognostic value of a cumulative acute cellular rejection "A-score" for long-term lung transplant outcomes
- evidence: Reduced lung fluid club cell secretory protein informs chronic lung allograft dysfunction risk
- evidence: Intra-subject variability in oscillometry correlates with acute rejection and CLAD post-lung transplant
- source of statement: Andrew Sage
- affects: Epithelial injury markers
- affects: Donor-derived cell-free DNA
- affects: Transbronchial biopsy: histology and transcript-based classifiers
Known gaps in this record
- which published biomarkers have been validated externally (no systematic source opened)
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.