Identification of patients at risk of kidney graft loss relies on early individual prediction of graft failure. Data from 616 kidney transplant recipients with a follow-up of at least one year were retrospectively studied. A joint latent class model investigating the impact of serum creatinine (Scr) time-trajectories and onset of de novo donor-specific anti-HLA antibody (dnDSA) on graft survival was developed. The capacity of the model to calculate individual predicted probabilities of graft failure over time was evaluated in 80 independent patients. The model classified the patients in three latent classes with significantly different Scr time profiles and different graft survivals. Donor age contributed to explaining latent class membership. In addition to the SCr classes, the other variables retained in the survival model were proteinuria measured one-year after transplantation (HR=2.4, p=0.01), pretransplant non-donor-specific antibodies (HR=3.3, p<0.001), and dnDSA in patient who experienced acute rejection (HR=15.9, p=0.02). In the validation dataset, individual predictions of graft failure risk provided good predictive performances (sensitivity, specificity, and overall accuracy of graft failure prediction at ten years were 77.7%, 95.8%, and 85%, resp.) for the 60 patients who had not developed dnDSA. For patients with dnDSA individual risk of graft failure was not predicted with a so good performance.

Background: The first wave of COVID-19 pandemic in Ireland was managed by a prolonged national lockdown. The second and third waves were managed by continued non-pharmaceutical interventions (NPIs) and deployment of a national vaccination programme. This paper aims to describe the epidemiological trends, Public Health restrictions and vaccination uptake during the first three waves of the pandemic.   Methods: Data on confirmed cases of COVID-19 from 1 March 2020 to 27 March 2021 were extracted from the national COVID-19 data hub, the Health Protection Surveillance Centre (HPSC) and the National Contact Management Programme. Vaccine uptake and epidemiological data from European Centre for Disease Prevention and Control were reported from four other EU states.  Results: Ireland experienced three distinct waves of COVID-19; first wave occurred March to August 2020, second August to November 2020 and third from November 2020 onwards. The third wave was attributable to emergence of the Alpha variant of concern (B.1.1.7 strain) and relaxation of public health restrictions in December 2020, when weekly mean number of close contacts per case peaked at 5.2. A similar epidemiological trajectory was observed across four other EU states.   Conclusions: Surges of COVID-19 continue to occur despite increasing vaccine coverage in the EU, due to the emergence of novel variants of concern and relaxation of Public Health restrictions. A “vaccine plus policy” is needed.

Background This study examines compliance with local travel restrictions and assesses early uptake of mask wearing, during the initial phase of the coronavirus disease of 2019 (COVID-19) pandemic in Ireland, to inform the ongoing outbreak response. Methods A series of four nationally representative telephone surveys were developed. Information was collected at a household level and from primary respondents. Multivariable logistic regression estimated the association between sociodemographic characteristics and compliance with the local travel restriction and with mask use in primary respondents. Results Household compliance with local travel restrictions was similar by region, household size and social position. 73.4% of all household members complied, with high levels maintained over time. Higher proportions reported travelling for non-permitted reasons with time. Older age, female gender and attending higher education were independently associated with compliance to local travel restrictions. Among primary respondents, no factors were independently associated with mask use. Conclusion High compliance with local travel restrictions during the early stages of the pandemic demonstrates the engagement of the population with public health guidance. Although high compliance with local travel restrictions was generally maintained over time, non-permitted activities increased. Early adoption of mask use before required by national policy or legislation provides further evidence of the responsiveness of the population.