Prevalence and immunohistochemical findings of subclinical kidney allograft rejection and its association with graft outcome

Clinical Transplantation
Francisco José Veríssimo VeroneseLuiz F Gonçalves

Abstract

Subclinical acute rejection (SAR) occurs in about 30% of stable renal transplant patients and may be a risk factor for a poor allograft outcome. In the present study, the prevalence and clinical features of subclinical rejection, and the expression of immune activation markers in surveillance graft biopsies were assessed and correlated with late graft outcomes. Protocol biopsies were obtained at 2 and 12 months post-transplant in 32 and 26 patients, respectively, with stable renal function. The Banff 1997 criteria were used for histological diagnosis. Graft function and survival and proteinuria were assessed during the 36 months of follow-up. Immunohistochemical evaluation of cell subpopulations and immunoactivation markers were performed on protocol biopsies. The prevalence of SAR at 2 months and of chronic allograft nephropathy (CAN) at 12 months in representative biopsies was 55 and 50%, respectively. Patients with SAR presented mononuclear cell infiltration with an increased expression of CD3, CD4, CD68, IL-2R and granzyme B. Kidney graft function was significantly worse in patients with SAR at 2 months who had chronic rejection on biopsy at 12 months, but SAR was not associated with a worse graft function, greater proteinu...Continue Reading

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Citations

Nov 10, 2005·Transplantation·Vincent AudardPhilippe Grimbert
Mar 15, 2006·Transplantation·Brian J Nankivell, Jeremy R Chapman
Oct 28, 2006·Drugs & Aging·Alain DuclosStuart M Flechner
Mar 28, 2013·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Claire CarteryNassim Kamar
Dec 1, 2010·Kidney International. Supplement·Johan W de Fijter
Jun 19, 2015·The Tohoku Journal of Experimental Medicine·Dong Ho ShinJieun Oh
Dec 2, 2006·Transplant Immunology·P J Yates, M L Nicholson
Jul 13, 2005·Clinical Transplantation·Francisco Veríssimo VeroneseLuiz Felipe Gonçalves
Jun 27, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B J Nankivell, J R Chapman
Oct 29, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Johan W de Fijter
Aug 21, 2008·Clinical Transplantation·Jose-Marie El-Amm, Scott A Gruber
Sep 3, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A ThierryG Touchard
Jul 15, 2015·Expert Opinion on Pharmacotherapy·Jamal BamoulidKlemens Budde

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