K Y Wu1, K Budde, D Schmidt, H H Neumayer, B Rudolph. 1. Medizinische Klinik mit Schwerpunkt Nephrologie, Charité Campus Mitte, Universitätsmedizin Berlin, Berlin, Germany.
Abstract
BACKGROUND: The impact of isolated v-lesions on clinical outcome in biopsies with acute cellular rejection (ACR) is unclear. METHODS: Two hundred and sixty-five biopsies showing the highest ACR severity for each patient were recruited and classified into four groups: (i) acute interstitial rejection (AIR) I with minimal tubulointerstitial inflammation (TI), (ii) AIR II with intensive TI, (iii) acute vascular rejection (AVR) I with minimal TI, and (iv) AVR II with intensive TI. RESULTS: The complete reversal rates of AIR I and AIR II groups were marginally higher than AVR I and AVR II groups (p = 0.16). At eight yr of transplantation, the death-censored graft survival (DCGS) rate of AIR I group (93.3%) was significantly higher compared with the AVR I (72.7%) or AVR II (72.9%) group. AVR I group had a similar DCGS rate with AVR II group (72.7% vs. 74.1%), whereas AVR with v1-lesion showed significantly higher graft survival (GS) rate than those with v2-lesion (70.2% vs. 45.5%). The t-lesion of AIR and v-lesion of AVR group were associated with graft loss. CONCLUSION: The extent of TI is non-specifically associated with graft loss in biopsies with AVR; the higher grade v-lesion predicts the lower complete reversal rate and poorer long-term graft survival.
BACKGROUND: The impact of isolated v-lesions on clinical outcome in biopsies with acute cellular rejection (ACR) is unclear. METHODS: Two hundred and sixty-five biopsies showing the highest ACR severity for each patient were recruited and classified into four groups: (i) acute interstitial rejection (AIR) I with minimal tubulointerstitial inflammation (TI), (ii) AIR II with intensive TI, (iii) acute vascular rejection (AVR) I with minimal TI, and (iv) AVR II with intensive TI. RESULTS: The complete reversal rates of AIR I and AIR II groups were marginally higher than AVR I and AVR II groups (p = 0.16). At eight yr of transplantation, the death-censored graft survival (DCGS) rate of AIR I group (93.3%) was significantly higher compared with the AVR I (72.7%) or AVR II (72.9%) group. AVR I group had a similar DCGS rate with AVR II group (72.7% vs. 74.1%), whereas AVR with v1-lesion showed significantly higher graft survival (GS) rate than those with v2-lesion (70.2% vs. 45.5%). The t-lesion of AIR and v-lesion of AVR group were associated with graft loss. CONCLUSION: The extent of TI is non-specifically associated with graft loss in biopsies with AVR; the higher grade v-lesion predicts the lower complete reversal rate and poorer long-term graft survival.
Authors: Banu Sis; Serena M Bagnasco; Lynn D Cornell; Parmjeet Randhawa; Mark Haas; Belinda Lategan; Alex B Magil; Andrew M Herzenberg; Ian W Gibson; Michael Kuperman; Kotaro Sasaki; Edward S Kraus Journal: J Am Soc Nephrol Date: 2014-11-07 Impact factor: 10.121
Authors: Mariana Wohlfahrtova; Petra Hruba; Jiri Klema; Marek Novotny; Zdenek Krejcik; Viktor Stranecky; Eva Honsova; Petra Vichova; Ondrej Viklicky Journal: Clin Sci (Lond) Date: 2018-10-29 Impact factor: 6.124