scholarly journals Gene Expression in Biopsies of Acute Rejection and Interstitial Fibrosis/Tubular Atrophy Reveals Highly Shared Mechanisms That Correlate With Worse Long-Term Outcomes

2016 ◽  
Vol 16 (7) ◽  
pp. 1982-1998 ◽  
Author(s):  
B. D. Modena ◽  
S. M. Kurian ◽  
L. W. Gaber ◽  
J. Waalen ◽  
A. I. Su ◽  
...  
Keyword(s):  
Gene Expression ◽  
Acute Rejection ◽  
Interstitial Fibrosis ◽  
Long Term Outcomes ◽  
Tubular Atrophy

scholarly journals Long-Term Outcomes in 831 Kidney Transplant Recipients with 20 Years of Graft Function

2021 ◽  
Vol 8 ◽  
Author(s):  
Varvara Kirchner ◽  
Kristen Gillingham ◽  
Oscar Serrano ◽  
Srinath Chinnakotla ◽  
Ty Dunn ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Survival ◽  
Interstitial Fibrosis ◽  
Graft Loss ◽  
Graft Function ◽  
Solid Organ ◽  
Kidney Transplant Recipients ◽  
Long Term Outcomes ◽  
Tubular Atrophy

An understanding of long-term outcomes for kidney transplant(KTx) recipients who survive with graft function beyond a specific time posttransplant is the first step in creating protocols to optimize care for current and improve outcomes for future recipients. We studied 831KTx recipients-580 living donor(LD); 251 deceased donor(DD)—with graft survival(GS) >20 years.  For primary LD recipients, 25-year patient survival(PS) was 83%; 35-year, 59%.  Their 25-year death-censored graft survival(DCGS) was 89%; 35-year, 72%.   DD recipients had lower PS(P<0.01), DCGS(P<0.01).   After 20 years, two major causes of graft loss(GL) were death with function(DwF)(58%, LD; 58%, DD) and interstitial fibrosis and tubular atrophy(IFTA)(22%, LD; 23%, DD).  Two major causes of DwF were cancer(31%, LD; 31%, DD) and cardiovascular disease(CVD)(19%, LD;17%, DD).  Per multivariate analysis(MVA), risk factors for GL after 20 years in pre–calcineurin inhibitor(CNI) era were human leukocyte antigen(HLA) mismatches >3 antigens, pretransplant type 1 diabetes mellitus(DM1); in CNI era, a history of rejection, female gender.  New comorbidities after 20 years were common: CVD(13%, non-DM1;18%, DM1), infections(27%, non-DM1;37%, DM1), 20-29 years posttransplant.  Cancer after 20 years included: nonmelanotic skin cancer,22%; solid organ,7%; post-transplant lymphoproliferative disease(PTLD),2%.  To improve long-term outcomes, clinical trials on prevention, recognition, and treatment of new comorbidities are needed.

scholarly journals Impact of the relationship between hemoglobin levels and renal interstitial fibrosis on long-term outcomes in type 2 diabetes with biopsy-proven diabetic nephropathy

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Miho Shimizu ◽  
Kengo Furuichi ◽  
Shinji Kitajima ◽  
Tadashi Toyama ◽  
Megumi Oshima ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Interstitial Fibrosis ◽  
Long Term Outcomes ◽  
Renal Interstitial Fibrosis ◽  
Tubular Atrophy ◽  
Tubulointerstitial Lesions ◽  
The Impact

Abstract Background Progression of renal anemia has been shown to be associated with advanced renal tubulointerstitial lesions. This retrospective study investigated the impact of lower hemoglobin (Hb) levels and renal interstitial fibrosis and tubular atrophy (IFTA) on long-term outcomes in type 2 diabetes with biopsy-proven diabetic nephropathy. Methods A total of 233 patients were enrolled. The severity of IFTA was scored according to the classification by the Renal Pathology Society. Patients were stratified according to baseline Hb tertiles by IFTA status. The outcomes were the first occurrence of renal events (requirement for dialysis or 50 % decline in estimated glomerular filtration rate from baseline) and all-cause mortality. Results At baseline, 151 patients had severe IFTA. There were no patients who have been received erythropoiesis-stimulating agents at the time of renal biopsy. The severity of IFTA was the independent pathological factor of lower Hb levels. During the mean follow-up period of 8.6 years (maximum, 32.4 years), 119 renal events and 42 deaths were observed. Compared with the combined influence of the highest tertile of Hb and mild IFTA, the risks of renal events were higher for the middle tertile and for the lowest tertile of Hb in severe IFTA, whereas the risk of renal events was higher for the lowest tertile of Hb in mild IFTA. The risk of mortality was higher for the lowest tertile of Hb only in severe IFTA. There were significant interactions of tertile of Hb and IFTA in renal events and mortality. Conclusions Impacts of lower Hb levels on long-term outcomes of diabetic nephropathy were greater in severe IFTA than in mild IFTA.

Intragraft vasculitis and gene expression analysis: Association with acute rejection and prediction of mortality in long-term heart transplantation

2018 ◽  
Vol 32 (10) ◽  
pp. e13373
Author(s):  
Hui Tzu Lin-Wang ◽  
Reginaldo Cipullo ◽  
João Italo Dias França ◽  
Marco Aurelio Finger ◽  
Joao Manoel Rossi Neto ◽  
...  
Keyword(s):  
Gene Expression ◽  
Acute Rejection ◽  
Heart Transplantation ◽  
Expression Analysis ◽  
Gene Expression Analysis ◽  
Prediction Of Mortality

Intragraft Tubular Vimentin and CD44 Expression Correlate With Long-Term Renal Allograft Function and Interstitial Fibrosis and Tubular Atrophy

2010 ◽  
Vol 90 (5) ◽  
pp. 502-509 ◽  
Author(s):  
Jesper Kers ◽  
Yi-Chun Xu-Dubois ◽  
Eric Rondeau ◽  
Nike Claessen ◽  
Mirza M. Idu ◽  
...  
Keyword(s):  
Renal Allograft ◽  
Interstitial Fibrosis ◽  
Tubular Atrophy ◽  
Cd44 Expression ◽  
Allograft Function

scholarly journals Gene Expression Changes Are Associated With Loss of Kidney Graft Function and Interstitial Fibrosis and Tubular Atrophy: Diagnosis Versus Prediction

2011 ◽  
Vol 91 (6) ◽  
pp. 657-665 ◽  
Author(s):  
Mariano J. Scian ◽  
Daniel G. Maluf ◽  
Kellie J. Archer ◽  
Jihee L. Suh ◽  
David Massey ◽  
...  
Keyword(s):  
Gene Expression ◽  
Interstitial Fibrosis ◽  
Graft Function ◽  
Kidney Graft ◽  
Tubular Atrophy

Acute Rejection as Key Predictor for Long-Term Outcomes after Kidney Transplantation?

2012 ◽  
Vol 94 (10S) ◽  
pp. 961
Author(s):  
D. K. Abendroth ◽  
M. Marzinzig ◽  
J. Kaden ◽  
M. J. Stangl ◽  
M. Raggi
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Long Term Outcomes

scholarly journals Association study of long-term kidney transplant rejection using whole-exome sequencing

2018 ◽  
Author(s):  
Louis Gioia ◽  
Sunil Kurian ◽  
Tony S. Mondala ◽  
Laia Bassaganyas ◽  
Pui-Yan Kwok ◽  
...  
Keyword(s):  
Interstitial Fibrosis ◽  
Transplant Rejection ◽  
Study Data ◽  
First Year ◽  
Post Transplantation ◽  
Tubular Atrophy ◽  
Association Analyses ◽  
Analysis Workflow ◽  
Meta Analyses

AbstractLong-term renal allograft rejection is the most common outcome in kidney transplantation. Continuing the crusade to extend allograft function after the first year post-transplantation, we attempted to associate genetic factors that might contribute to long-term allograft outcomes by sequencing the exomes of patients diagnosed with chronic allograft nephropathy/interstitial fibrosis and tubular atrophy. A variety of association analyses were employed, but these analyses failed to identify statistically significant associations. The study was underpowered to detect the association of rare genomic variants with small effect sizes. However, it confirmed previous reports of the absence of large effects from common variants. We have made both the study data and analysis workflow available for public use, and we hope that these resources will help to power future meta-analyses that may detect smaller effects.

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