Sub-clinical acute rejection detected using protocol biopsies in patients with delayed graft function

2000 ◽  
Vol 13 (7) ◽  
pp. S52-S55 ◽  
Author(s):  
S. Jain ◽  
V. Curwood ◽  
S. A. White ◽  
P. N. Furness ◽  
M. L. Nicholson
Keyword(s):  
Acute Rejection ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Protocol Biopsies

scholarly journals Sub-clinical acute rejection detected using protocol biopsies in patients with delayed graft function

2000 ◽  
Vol 13 (S1) ◽  
pp. S52-S55 ◽  
Author(s):  
S. Jain ◽  
V. Curwood ◽  
S.A. White ◽  
P.N. Furness ◽  
M.L. Nicholson
Keyword(s):  
Acute Rejection ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Protocol Biopsies

scholarly journals Activation of final complement components after kidney transplantation as a marker of delayed graft function severity

2020 ◽  
Author(s):  
Carlos E Arias-Cabrales ◽  
Marta Riera ◽  
María José Pérez-Sáez ◽  
Javier Gimeno ◽  
David Benito ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Graft Function ◽  
Basal Membrane ◽  
Factor H ◽  
Delayed Graft Function ◽  
Control Group ◽  
Complement Factor ◽  
Tubular Epithelial Cells ◽  
Complement Components ◽  
Protocol Biopsies

Abstract Background Ischaemia–reperfusion (I/R) damage is a relevant cause of delayed graft function (DGF). Complement activation is involved in experimental I/R injury, but few data are available from kidney transplant (KT) patients. We studied the dynamics of membrane attack complex (C5b-9) as a soluble fraction (SC5b-9) and the histological deposit pattern of C3b, complement Factor H (FH) and C5b-9 in DGF patients. Methods We evaluated SC5b-9 levels in 59 recipients: 38 with immediate graft function and 21 with DGF. The SC5b-9 was measured at admission for KT and 7 days after KT. DGF-kidney biopsies (n = 12) and a control group of 1-year protocol biopsies without tissue damage (n = 4) were stained for C5b-9, C3b and FH. Results SC5b-9 increased significantly in DGF patients (Day 0: 6621 ± 2202 mAU/L versus Day 7: 9626 ± 4142  mAU/L; P = 0.006), while it remained stable in non-DGF patients. Days 0–7 increase >5% was the better cut-off associated with DGF versus non-DGF patient discrimination (sensitivity = 81%). In addition, SC5b-9 increase was related to DGF duration and worse graft function, and independently associated with DGF occurrence. SC5b-9, C3b and FH stains were observed in tubular epithelial cells basal membrane. DGF-kidney biopsies showed a more frequently high-intensity stain, a higher number of tubules with positive stain and larger perimeter of tubules with positive stains for SC5b-9, C3b and FH than control patients. Conclusions Both SC5b-9 levels and SC5b-9, C3b and FH deposits in tubular epithelial cells basal membrane are highly expressed in patients experiencing DGF. SC5b-9 levels increase could be useful as a marker of DGF severity.

Delayed Graft Function: Risk Factors and the Effects of Early Function and Acute Rejection

2012 ◽  
Vol 94 (10S) ◽  
pp. 1026
Author(s):  
M. Miglinas ◽  
L. Supranaviciene ◽  
A. Kubiliene ◽  
K. Mateikaite ◽  
K. Skebas
Keyword(s):  
Risk Factors ◽  
Acute Rejection ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Early Function

MO941CLINICAL OUTCOMES IN KIDNEY RE-TRANSPLANTATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Clara Pardinhas ◽  
Rita Leal ◽  
Francisco Caramelo ◽  
Teofilo Yan ◽  
Carolina Figueiredo ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Graft Failure ◽  
Graft Function ◽  
Delayed Graft Function ◽  
First Year ◽  
Kidney Transplant Recipients ◽  
Post Transplant

Abstract Background and Aims As kidney transplants are growing in absolute numbers, so are patients with failed allografts and thus potential candidates for re-transplantation. Re-transplantation is challenging due to immunological barriers, surgical difficulties and clinical complexities but it has been proven that successful second transplantation improves life expectancy over dialysis. It is important to evaluate re-transplantation outcomes since 20% of patients on the waiting list are waiting for a second graft. Our aim was to compare major clinical outcomes such as acute rejection, graft and patient survival, between patients receiving a first or a second kidney transplant. Method We performed a retrospective study, that included 1552 patients submitted to a first (N=1443, 93%) or a second kidney transplant (N=109, 7%), between January 2008 and December 2018. Patients with more than 2 grafts or multi-organ transplant were excluded. Demographic, clinical and histocompatibility characteristics of both groups were registered from our unit database and compared. Delayed graft function was defined has the need of dialysis in the first week post-transplant. All acute rejection episodes were biopsy proven, according to Banff 2017 criteria. Follow-up time was defined at 1st June 2020 for functioning grafts or at graft failure (including death with a functioning graft). Results Recipients of a second graft were significantly younger (43 ±12 vs 50 ± 13 years old, p<0.001) and there were significantly fewer expanded-criteria donors in the second transplant group (31.5% vs 57.5%, p<0.001). The waiting time for a second graft was longer (63±50 vs 48±29 months, p=0.011). HLA mismatch was similar for both groups but PRA was significantly higher for second KT patients (21.6±25% versus 3±9%; p<0.001). All patients submitted to a second KT had thymoglobulin as induction therapy compared to 16% of the first KT group (p<0.001). We found no difference in primary dysfunction or delayed graft function between groups. Acute rejection was significantly more frequent in second kidney transplant recipients (19% vs 5%, p<0.001), being 10 acute cellular rejections, 7 were antibody mediated and 3 were borderline changes. For the majority of the patients (85%), acute rejection occurred in the first-year post-transplant. Death censored graft failure occurred in 236 (16.4%) patients with first kidney transplant and 25 (23%) patients with a second graft, p=0.08. Survival analysis showed similar graft survival for both groups (log-rank p=0.392). We found no difference in patients’ mortality at follow up for both groups. Conclusion Although second graft patients presented more episodes of biopsy proven acute rejection, especially at the first-year post-transplant, we found no differences in death censored graft survival or patients’ mortality for patients with a second kidney transplant. Second transplants should be offered to patients whenever feasible.

scholarly journals P1656THE IMPACT OF PRE-TRANSPLANT DIALYSIS MODALITY ON EARLY POST-TRANSPLANT PERIOD ADVERSE EVENTS : A PROSPECTIVE COHORT STUDY WITH PROPENSITY SCORE MATCHING

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hyo Jin Boo ◽  
Wooseong Huh ◽  
Yon su Kim ◽  
Chul-Woo Yang ◽  
Yong-Lim Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Acute Rejection ◽  
Propensity Score Matching ◽  
Graft Function ◽  
Total Duration ◽  
Early Period ◽  
Delayed Graft Function ◽  
Dialysis Modality ◽  
Composite Outcomes

Abstract Background and Aims Among peritoneal dialysis (PD) or hemodialysis (HD) while waiting for a kidney transplant (KT), which is better in terms of KT outcomes has long been of interest. Nowadays it is difficult to agree on which modality is better. The primary objective of this study was to compare the incidence of composite outcomes (delayed graft function, primary non-function, biopsy-proven acute rejection) within 1 year after primary adult KT between recipients taken PD and HD before KT (PD group vs. HD group, respectively). Method This study was a prospective, multi-sites cohort study. We used a propensity score matching to control for patients characteristics. Results Total 1040 patients were enrolled consecutively. Among them, 1030 patients (248, PD group; 782, HD group) were included in the final analysis. The HD group was older and had higher prevalence of diabetes, higher Charlson comorbidity index score, higher prevalence of positive PRA and more prescription of rituximab than the PD group significantly. After propensity score matching (246, PD group; 476, HD group), there were no differences in baseline characteristics between the two groups. In the whole population, there was no difference in the risk of the composite outcomes between the PD and HD groups (19% vs. 17%, hazard ratio [HR] 1.25, 95% confidence interval [CI] 0.88 ∼ 1.77, p = 0.21). There were also no differences in the risk of each component in the composite outcomes between the two groups. Primary non-function, a component of the composite outcomes did not occur in the both groups. There were no differences in the risks of death, frequency and total duration of re-hospitalization after KT for 1 year, and the changes of eGFR for 1 year between the two groups. The results from the propensity score matched population were consistent with those from the whole population. There was no difference in the risk of the composite outcomes between the PD and HD groups (19% vs. 17%, HR 1.17, 95% CI 0.80 ∼ 1.74, p = 0.43). Conclusion The pre-transplant dialysis modality does not affect the incidences of delayed graft function and acute rejection in early period of KT. (NCT01513707) This study was supported by Baxter Incorporated.

Donor Age Amplifies the Detrimental Effects of Cold Ischemia Time on Long-Term Kidney Allograft Survival Independently of the Occurrence of Delayed Graft Function or Early Acute Rejection

2020 ◽  
Vol 18 (4) ◽  
pp. 436-443
Author(s):  
Pedro Rincon Cintra da Cruz ◽  
Aderivaldo Cabral Dias Filho ◽  
Viviane Brandão Bandeira Mello Santana ◽  
Rubia Bethania Biela Boaretto ◽  
Cassio Luis Zanettini Riccetto
Keyword(s):  
Acute Rejection ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Cold Ischemia Time ◽  
Donor Age ◽  
Allograft Survival ◽  
Cold Ischemia ◽  
Kidney Allograft ◽  
Ischemia Time
Sign in / Sign up

Export Citation Format

Share Document