An observational study in Kidney Transplantation, sponsored by Paris Translational Research Center for Organ Transplantation. Completed. Open to participants aged 0 Years to 100 Years. Per ClinicalTrials.gov, last updated 2025-06-04.
Sponsored by Paris Translational Research Center for Organ Transplantation · Observational
Kidney allograft rejection diagnosis relies on the complex Banff classification, but its application is limited by variability and workload. Our group previously built a scripted automation system, though it required major expert input. This study assesses whether modern LLMs can achieve similar diagnostic performance using Banff-based prompts, without extensive manual engineering.
Kidney allograft rejection remains a leading cause of allograft failure. Histological diagnosis relies on the Banff classification, a complex and evolving rule based framework. While successive Banff working groups refined the guidelines over time, daily interpretation is still hampered by inter and intra pathologist variability and growing demands on renal pathologists. This is why our group previously built a fully scripted Banff automation system. However, this system demanded years of expert curation and bespoke code before reaching acceptable accuracy. Whether modern LLMs, which show high capabilities to generate consistent and transparent reasoning at scale, can match expert pathologists without such resource intensive engineering remains unknown. The present study was therefore designed to benchmark state of the art LLMs against consensus diagnoses from senior renal pathologists on a representative series of kidney allograft biopsies, and to explore whether properly engineered prompts can translate Banff rules into reliable, reproducible diagnostic output.
Paris Translational Research Center for Organ Transplantation is the lead sponsor of 31 studies on the registry; 7 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Kidney recipients
Exclusion Criteria:
Transplant unit from Necker hospital, France
Transplant unit from Saint-Louis hospital, France
Biopsy diagnosis
The diagnosis of the biopsy will be based on the latest Banff classification (2022). The diagnoses will include i) biopsies with nonspecific lesions or clean (n=40), ii) biopsies with antibody-mediated rejection (AMR) (n=40) among which 14 had acute AMR, 13 chronic active AMR and 13 chronic inactive AMR, iii) biopsies with T cell-mediated rejection (TCMR) (n=40), among which 20 had acute TCMR and 20 had chronic active TCMR, iv) biopsies with borderline for acute TCMR (n=40), v) biopsies with mixed rejection (n=40), and vi) biopsies with microvascular inflammation (MVI) (n=40) among which 20 had probable AMR and 20 had MVI without DSA and without C4d.
Time frame: The biopsy will be protocol biopsies performed at 3 months and 1 year post transplant, or for-cause biopsies performed at any time post transplant.
No study locations are listed for this record.
Plan to share: Undecided
No publications or documents are linked to this record.
This study is completed, as verified in May 2025. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Paris Translational Research Center for Organ Transplantation