+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Risk factors for Banff borderline acute rejection in protocol biopsies and effect on renal graft function



Risk factors for Banff borderline acute rejection in protocol biopsies and effect on renal graft function



Transplantation Proceedings 42(6): 2376-2378



The interpretation and handling of Banff borderline acute rejection observed in protocol biopsies from patients with stable renal function continues to be controversial. Our objective was to identify the risk factors for borderline acute rejection on 1-year protocol biopsies and to evaluate their effect on renal graft function after 2 years' follow-up. We included 82 kidney transplant recipients (KTR), who underwent 1-year protocol biopsies with normal or stable graft function. All KTR had follow-up of at least 2 years posttransplantation. We formed three groups: (1) KTR with a normal biopsy, (2) KTR with borderline changes, and (3) KTR with interstitial fibrosis/tubular atrophy (IF/TA). We searched for risk factors related to borderline injury. The main outcome to evaluate was renal function at 1 month, at protocol biopsy, and 2 years posttransplant. The 82 patients included in this study showed no differences in immunosuppression, gender, etiology of renal failure, or percentage of panel-reactive antibodies. The risk factors associated with borderline lesions were: at least one biopsy due to allograft dysfunction and acute rejection events during the first year posttransplant (P = .011 and P = .021, respectively). Increased serum creatinine and estimated glomerular filtration rate decline were greater among the borderline lesion than the normal group, but similar to patients with IF/TA. Renal function decline was greater among borderline and IF/TA groups. However, the sum of insults, and not only the borderline injury itself, produces greater declines in renal function with greater risk for graft loss.

(PDF emailed within 0-6 h: $19.90)

Accession: 055580015

Download citation: RISBibTeXText

PMID: 20692484

DOI: 10.1016/j.transproceed.2010.05.008


Related references

The relationship of untreated borderline infiltrates by the Banff criteria to acute rejection in renal allograft biopsies. Journal of the American Society of Nephrology 10(8): 1806-1814, 1999

Weekly protocol renal transplant biopsies allow detection of sub-clinical acute rejection episodes in patients with delayed graft function. Transplantation Proceedings 32(1): 191-191, 2000

Impact of CMV infection on acute rejection and long-term renal allograft function: a systematic analysis in patients with protocol biopsies and indicated biopsies. Nephrology, Dialysis, Transplantation 27(1): 435-443, 2012

Sub-clinical acute rejection detected using protocol biopsies in patients with delayed graft function. Transplant International 13 Suppl 1: S52-S55, 2000

Early graft function modulates the risk for acute rejection and the effect of AR on renal graft survival. Journal of the American Society of Nephrology 7(9): 1907, 1996

Impact of Banff borderline acute rejection among renal allograft recipients. Transplantation Proceedings 40(7): 2303-2306, 2008

Risk factors for acute rejection in renal transplant recipients experiencing delayed graft function. Clinical Transplantation 22(5): 634-638, 2008

Validation of the Banff criteria for acute rejection in renal transplant biopsies. Australian & New Zealand Journal of Medicine 25(6): 681-687, 1995

Delayed graft function: risk factors and the relative effects of early function and acute rejection on long-term survival in cadaveric renal transplantation. Clinical Transplantation 13(3): 266-272, 1999

Untreated rejection in 6-month protocol biopsies is not associated with fibrosis in serial biopsies or with loss of graft function. Journal of the American Society of Nephrology 17(9): 2622-2632, 2006

Subclinical rejection and borderline changes in early protocol biopsies following renal transplantation. Journal of the American Society of Nephrology 14(Abstracts Issue): 433A, November, 2003

Is the incidence of acute rejection high enough to warrant protocol biopsies during delayed renal allograft function?. Journal of the American Society of Nephrology 11(Program and Abstract Issue): 703A, September, 2000

Acute tubular injury in protocol biopsies of renal grafts: prevalence, associated factors and effect on long-term function. American Journal of Transplantation 8(8): 1684-1693, 2008

Late acute rejection: incidence, risk factors, and effect on graft survival and function. Pediatric Transplantation 18(2): 155-162, 2014

The Banff classification of severity of allograft rejection in graft biopsies related to 1/2 and 1 year graft survival. Journal of the American Society of Nephrology 4(3): 938, 1993