Analysis of histologic changes during early rejection after renal transplantation by performing protocol biopsy at 1 year after kidney transplantation.

Abstract

BACKGROUND:

In this retrospective study, we analyzed histologic changes identified through protocol biopsy (PB) at 1 year after kidney transplantation (KT). We focused on the pathologic changes observed in patients with a history of treatment for graft rejection within 1 year of transplantation.

METHODS:

Between January 2008 and December 2011, 56 patients underwent KT at our center. We assessed the histologic findings observed at 1 year after renal transplantation using the Banff 2007 classification. At our center, PBs are performed immediately after or at 1 hour after transplantation, and at 1 year after KT. PBs were performed in 39 patients; PBs could not be performed in 17 patients because of various causes. Of the 39 patients, 29 stabilized without clinical rejection and without treatment (the NTx group); 10 patients showed pathologic changes or clinical rejection after steroid pulse therapy within 1 year (the Tx group). We compared these 2 groups with respect to baseline data, renal function, and pathologic scores.

RESULTS:

The interstitial fibrosis ("ci") score, according to the Banff classification, was significantly greater in the NTx group (0.89) than in the Tx group (0.50) at 1 year after transplantation.

CONCLUSIONS:

The currently applied early steroid withdrawal regimen may be not be ideal for preventing pathologic changes occurring after KT. In addition to the PB performed 1 year after KT, PB should be performed within 1 year of renal transplantation to identify early signs of rejection and to provide access to appropriate treatment regimes.

• Authors: T Yokoyama, O Konno, Y Nakamura, Y Kihara, H Iwamoto, M Shimazu
• Journal: Transplantation proceedings (Transplant Proc) Vol. 46 Issue 2 Pg. 349-52 ( 2014) ISSN: 1873-2623 [Electronic] United States
• PMID: 24655961 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Immunosuppressive Agents

Topics

• Adult
• Biopsy
• Female
• Graft Rejection
• Humans
• Immunosuppressive Agents (administration & dosage)
• Kidney (pathology)
• Kidney Transplantation
• Male
• Middle Aged