Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis
The clinical merit of surveillance kidney graft biopsies remains controversial. A retrospective, multicenter analysis evaluated 12-month surveillance biopsies (SB, 154 patients) versus no SB (NSB, 138 patients (11 with diagnostic biopsy)) in patients >18 months posttransplant with estimated GFR (...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2012/781263 |
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| author | Bruno Moulin Pierre Merville Karine Renaudin David Buob Sophie Ferlicot Michel Delahousse Jacques Dantal Laetitia Albano Christelle Barbet Georges Mourad Laure-Hélène Noel |
| author_facet | Bruno Moulin Pierre Merville Karine Renaudin David Buob Sophie Ferlicot Michel Delahousse Jacques Dantal Laetitia Albano Christelle Barbet Georges Mourad Laure-Hélène Noel |
| author_sort | Bruno Moulin |
| collection | DOAJ |
| description | The clinical merit of surveillance kidney graft biopsies remains controversial. A retrospective, multicenter analysis evaluated 12-month surveillance biopsies (SB, 154 patients) versus no SB (NSB, 138 patients (11 with diagnostic biopsy)) in patients >18 months posttransplant with estimated GFR (eGFR) ≥30 mL/min. The primary objective was to describe renal function at 18 months post-transplant in patients with or without SB at month 12. Globally, most recipients in both cohorts were at low immunological risk (<10% of patients with PRA ≥30%). The immunosuppressive regimen remained unchanged following more than half of SB that exhibited chronic lesions (18/33, 54.5%). Mean (SD) eGFR at month 18 (primary endpoint) was 56 (19) mL/min/1.73 m² with SB and 54 (15) mL/min/1.73 m² with NSB (𝑃=0.48). In the SB group, slight nonspecific changes were observed in 51 cases, rejection (acute or chronic) in 6 cases, CNI-related toxicity in 15 cases, recurrence of initial disease in two cases, and interstitial fibrosis/tubular atrophy (IF/TA) in 83 cases (71.6%), of which 35 cases (30.2%) were grade II/III lesions. eGFR <50 mL/min/1.73 m² at month 6 predicted IF/TA grade II or III (OR 3.85, 95% CI 1.64, 9.05, 𝑃<0.002). SB at 12 months posttransplant did not prompt significant modification of immunosuppression, and no renal benefit was observed. |
| format | Article |
| id | doaj-art-8180176573c64a3fb772e87450b75ef4 |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-8180176573c64a3fb772e87450b75ef42025-02-03T01:27:44ZengWileyJournal of Transplantation2090-00072090-00152012-01-01201210.1155/2012/781263781263Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational AnalysisBruno Moulin0Pierre Merville1Karine Renaudin2David Buob3Sophie Ferlicot4Michel Delahousse5Jacques Dantal6Laetitia Albano7Christelle Barbet8Georges Mourad9Laure-Hélène Noel10Service de Néphrologie-Transplantation, CHU Strasbourg, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, FranceService de Néphrologie-Transplantation-Dialyse, CHU Bordeaux, 33076 Bordeaux, FranceService d’Anatomie Pathologique, Centre Hospitalier Universitaire Hôtel Dieu, 44093 Nantes, FranceInstitut de Pathologie, CHRU de Lille and EA2686, Université Lille Nord de France, 59037 Lille, FranceService d'Anatomie et de Cytologie Pathologiques, Université Paris-Sud 11, APHP Hôpital de Bicêtre, 94270 Le Kremlin-Bicêtre, FranceService de Néphrologie et Transplantation, Foch Hospital, 92151 Suresnes, FranceInstitut de Transplantation, Urologie et Néphrologie CHU Nantes, 44093 Nantes, FranceService de Néphrologie et Transplantation Rénale, Hôpital Pasteur, 06002 Nice, FranceService de Néphrologie-Transplantation Rénale, Hôpital Bretonneau, 37044 Tours, FranceService de Néphrologie et Transplantation Rénale, Hôpital Lapeyronie, 34295 Montpellier, FranceINSERM, Service de Transplantation, Service d’Anatomie Pathologique, Université René Descartes, Hôpital Necker, 75015 Paris, FranceThe clinical merit of surveillance kidney graft biopsies remains controversial. A retrospective, multicenter analysis evaluated 12-month surveillance biopsies (SB, 154 patients) versus no SB (NSB, 138 patients (11 with diagnostic biopsy)) in patients >18 months posttransplant with estimated GFR (eGFR) ≥30 mL/min. The primary objective was to describe renal function at 18 months post-transplant in patients with or without SB at month 12. Globally, most recipients in both cohorts were at low immunological risk (<10% of patients with PRA ≥30%). The immunosuppressive regimen remained unchanged following more than half of SB that exhibited chronic lesions (18/33, 54.5%). Mean (SD) eGFR at month 18 (primary endpoint) was 56 (19) mL/min/1.73 m² with SB and 54 (15) mL/min/1.73 m² with NSB (𝑃=0.48). In the SB group, slight nonspecific changes were observed in 51 cases, rejection (acute or chronic) in 6 cases, CNI-related toxicity in 15 cases, recurrence of initial disease in two cases, and interstitial fibrosis/tubular atrophy (IF/TA) in 83 cases (71.6%), of which 35 cases (30.2%) were grade II/III lesions. eGFR <50 mL/min/1.73 m² at month 6 predicted IF/TA grade II or III (OR 3.85, 95% CI 1.64, 9.05, 𝑃<0.002). SB at 12 months posttransplant did not prompt significant modification of immunosuppression, and no renal benefit was observed.http://dx.doi.org/10.1155/2012/781263 |
| spellingShingle | Bruno Moulin Pierre Merville Karine Renaudin David Buob Sophie Ferlicot Michel Delahousse Jacques Dantal Laetitia Albano Christelle Barbet Georges Mourad Laure-Hélène Noel Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis Journal of Transplantation |
| title | Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis |
| title_full | Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis |
| title_fullStr | Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis |
| title_full_unstemmed | Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis |
| title_short | Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis |
| title_sort | evaluation of protocol biopsy utility 12 months after renal transplantation a multicenter observational analysis |
| url | http://dx.doi.org/10.1155/2012/781263 |
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