Browsing by Subject "RENAL-ALLOGRAFT REJECTION"

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  • Ortiz, Fernanda; Gelpi, Rosana; Helanterä, Ilkka; Melilli, Edoardo; Honkanen, Eero; Bestard, Oriol; Grinyo, Josep M.; Cruzado, Josep M. (2016)
    Introduction The pros and cons for implementing protocol biopsies (PB) after kidney transplantation are still a matter of debate. We aimed to address the frequency of pathological findings in PB, to analyze their impact on long-term graft survival (GS) and to analyze the risk factors predicting an abnormal histology. Methods We analyzed 946 kidney PB obtained at a median time of 6.5 (+/- 2.9) months after transplantation. Statistics included comparison between groups, Kaplan-Meier and multinomial logistic regression analysis. Results and Discussion PB diagnosis were: 53.4% normal; 46% IFTA; 12.3% borderline and 4.9% had subclinical acute rejection (SCAR). Inflammation had the strongest negative impact on GS. Therefore we split the cases into: "normal without inflammation", "normal with inflammation", "IFTA without inflammation", "IFTA with inflammation" and "rejection" (including SCAR and borderline). 15-year GS in PB diagnosed normal with inflammation was significantly decreased in a similar fashion as in rejection cases. Among normal biopsies, inflammation increased significantly the risk of 15-y graft loss (P = 0.01). Variables that predicted an abnormal biopsy were proteinuria, previous AR and DR-mismatch. Conclusion We conclude that inflammation in normal PB is associated with a significantly lower 15-y GS, comparable to rejection or IFTA with inflammation.
  • Knobler, R.; Berlin, G.; Calzavara-Pinton, P.; Greinix, H.; Jaksch, P.; Laroche, L.; Ludvigsson, J.; Quaglino, P.; Reinisch, W.; Scarisbrick, J.; Schwarz, T.; Wolf, P.; Arenberger, P.; Assaf, C.; Bagot, M.; Barr, M.; Bohbot, A.; Bruckner-Tuderman, L.; Dreno, B.; Enk, A.; French, L.; Gniadecki, R.; Gollnick, H.; Hertl, M.; Jantschitsch, C.; Jung, A.; Just, U.; Klemke, C. -D.; Lippert, U.; Luger, T.; Papadavid, E.; Pehamberger, H.; Ranki, A.; Stadler, R.; Sterry, W.; Wolf, I. H.; Worm, M.; Zic, J.; Zouboulis, C. C.; Hillen, U. (2014)