INTRODUCTION: Transplant glomerulopathy (TG) is usually associated with a poor prognosis for kidney graft survival. AIM AND METHODS: We analyzed 30 cases of TG diagnosed by kidney biopsy among a retrospective review of 579 biopsies performed between January 2006 and October 2011. RESULTS: At the time of biopsy, the mean glomerular filtration rate (GFR), estimated by the abbreviated Modification of Diet in Renal Disease was 31 ± 10 mL/min and the proteinuria, 1.9 ± 2 gr/24 hours. Anti-human leukocyte antigen (HLA) antibodies were present in 40% of patients. The histological findings showed severe duplication of the glomerular basement membrane in 80% of patients; and interstitial fibrosis and tubular atrophy (IFTA) and moderate to severe arteriolar hyalinosis in 53% and 56% respectively. Fourteen patients lost their grafts. Graft survival was significantly associated with IFTA (P = .03) and renal function at the time of diagnosis (P = .03). CONCLUSIONS: TG was associated with a worse prognosis for the graft among kidney transplant patients. It is often associated with the presence of anti-HLA antibodies. Renal function at the time of diagnosis and IFTA were predictive factors for graft survival in these patients.
INTRODUCTION:Transplant glomerulopathy (TG) is usually associated with a poor prognosis for kidney graft survival. AIM AND METHODS: We analyzed 30 cases of TG diagnosed by kidney biopsy among a retrospective review of 579 biopsies performed between January 2006 and October 2011. RESULTS: At the time of biopsy, the mean glomerular filtration rate (GFR), estimated by the abbreviated Modification of Diet in Renal Disease was 31 ± 10 mL/min and the proteinuria, 1.9 ± 2 gr/24 hours. Anti-human leukocyte antigen (HLA) antibodies were present in 40% of patients. The histological findings showed severe duplication of the glomerular basement membrane in 80% of patients; and interstitial fibrosis and tubular atrophy (IFTA) and moderate to severe arteriolar hyalinosis in 53% and 56% respectively. Fourteen patients lost their grafts. Graft survival was significantly associated with IFTA (P = .03) and renal function at the time of diagnosis (P = .03). CONCLUSIONS: TG was associated with a worse prognosis for the graft among kidney transplant patients. It is often associated with the presence of anti-HLA antibodies. Renal function at the time of diagnosis and IFTA were predictive factors for graft survival in these patients.
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Authors: Gastón J Piñeiro; Erika De Sousa-Amorim; Manel Solé; José Ríos; Miguel Lozano; Frederic Cofán; Pedro Ventura-Aguiar; David Cucchiari; Ignacio Revuelta; Joan Cid; Eduard Palou; Josep M Campistol; Federico Oppenheimer; Jordi Rovira; Fritz Diekmann Journal: BMC Nephrol Date: 2018-10-11 Impact factor: 2.388