LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS
Rejection has always been one of the most important cause of late renal graft dysfunction. Aim of the study was to analyze the prevalence of different clinico-pathological variants of rejection that cause late graft dysfunction, and evaluate their impact on long-term outcome. Materials and methods....
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| Format: | Article |
| Language: | Russian |
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Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2014-05-01
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| Series: | Вестник трансплантологии и искусственных органов |
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| Online Access: | https://journal.transpl.ru/vtio/article/view/199 |
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| author | E.S. Stolyarevich L.Y. Artyukhina I.G. Kim L.G. Kurenkova N.A. Tomilina |
| author_facet | E.S. Stolyarevich L.Y. Artyukhina I.G. Kim L.G. Kurenkova N.A. Tomilina |
| author_sort | E.S. Stolyarevich |
| collection | DOAJ |
| description | Rejection has always been one of the most important cause of late renal graft dysfunction. Aim of the study was to analyze the prevalence of different clinico-pathological variants of rejection that cause late graft dysfunction, and evaluate their impact on long-term outcome. Materials and methods. This is a retrospective study that analyzed 294 needle core biopsy specimens from 265 renal transplant recipients with late (48,8 ± 46,1 months after transplantation) allograft dysfunction caused by late acute rejection (LAR, n = 193) or chronic rejection (CR, n = 78) or both (n = 23). C4d staining was performed by immunofl uorescence (IF) on frozen sections using a standard protocol. Results. Peritubular capillary C4d deposition was identifi ed in 36% samples with acute rejection and in 62% cases of chronic rejection (including 67% cases of transplant glomerulopathy, and 50% – of isolated chronic vasculopathy). 5-year graft survival for LAR vs CR vs their combination was 47, 13 and 25%, respectively. The outcome of C4d– LAR was (p < 0,01) better than of C4d+ acute rejection: at 60 months graft survival for diffuse C4d+ vs C4d− was 33% vs 53%, respectively. In cases of chronic rejection C4d+ vs C4d– it was not statistically signifi cant (34% vs 36%). Conclusion. In long-term allograft biopsy C4d positivity is more haracteristic for chronic rejection than for acute rejection. Only diffuse C4d staining affects the outcome. C4d– positivity is associated with worse allograft survival in cases of late acute rejection, but not in cases of chronic rejection. |
| format | Article |
| id | doaj-art-018cd73e389e4a2abe65c72c9b280b3a |
| institution | Kabale University |
| issn | 1995-1191 |
| language | Russian |
| publishDate | 2014-05-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj-art-018cd73e389e4a2abe65c72c9b280b3a2025-08-20T03:44:23ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912014-05-01162303810.15825/1995-1191-2014-2-30-38142LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSISE.S. Stolyarevich0L.Y. Artyukhina1I.G. Kim2L.G. Kurenkova3N.A. Tomilina4Division of nephrology, V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation Chair of Nephrology, Moscow University of Medicine and Dentistry, Moscow, Russian Federation Moscow City Hospital N 52, Russian FederationMoscow City Hospital N 52, Russian FederationDivision of nephrology, V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation Moscow City Hospital N 52, Russian FederationClinical pathology division at the same centerDivision of nephrology, V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation Chair of Nephrology, Moscow University of Medicine and Dentistry, Moscow, Russian Federation Moscow City Hospital N 52, Russian FederationRejection has always been one of the most important cause of late renal graft dysfunction. Aim of the study was to analyze the prevalence of different clinico-pathological variants of rejection that cause late graft dysfunction, and evaluate their impact on long-term outcome. Materials and methods. This is a retrospective study that analyzed 294 needle core biopsy specimens from 265 renal transplant recipients with late (48,8 ± 46,1 months after transplantation) allograft dysfunction caused by late acute rejection (LAR, n = 193) or chronic rejection (CR, n = 78) or both (n = 23). C4d staining was performed by immunofl uorescence (IF) on frozen sections using a standard protocol. Results. Peritubular capillary C4d deposition was identifi ed in 36% samples with acute rejection and in 62% cases of chronic rejection (including 67% cases of transplant glomerulopathy, and 50% – of isolated chronic vasculopathy). 5-year graft survival for LAR vs CR vs their combination was 47, 13 and 25%, respectively. The outcome of C4d– LAR was (p < 0,01) better than of C4d+ acute rejection: at 60 months graft survival for diffuse C4d+ vs C4d− was 33% vs 53%, respectively. In cases of chronic rejection C4d+ vs C4d– it was not statistically signifi cant (34% vs 36%). Conclusion. In long-term allograft biopsy C4d positivity is more haracteristic for chronic rejection than for acute rejection. Only diffuse C4d staining affects the outcome. C4d– positivity is associated with worse allograft survival in cases of late acute rejection, but not in cases of chronic rejection.https://journal.transpl.ru/vtio/article/view/199kidney transplantation, humoral rejection, c4d. |
| spellingShingle | E.S. Stolyarevich L.Y. Artyukhina I.G. Kim L.G. Kurenkova N.A. Tomilina LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS Вестник трансплантологии и искусственных органов kidney transplantation, humoral rejection, c4d. |
| title | LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS |
| title_full | LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS |
| title_fullStr | LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS |
| title_full_unstemmed | LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS |
| title_short | LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS |
| title_sort | late renal graft rejection pathology and prognosis |
| topic | kidney transplantation, humoral rejection, c4d. |
| url | https://journal.transpl.ru/vtio/article/view/199 |
| work_keys_str_mv | AT esstolyarevich laterenalgraftrejectionpathologyandprognosis AT lyartyukhina laterenalgraftrejectionpathologyandprognosis AT igkim laterenalgraftrejectionpathologyandprognosis AT lgkurenkova laterenalgraftrejectionpathologyandprognosis AT natomilina laterenalgraftrejectionpathologyandprognosis |