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Early interstitial macrophage infiltration with mild dysfunction is associated with subsequent kidney graft loss
- Publication Year :
- 2019
- Publisher :
- Blackwell Publishing Ltd, 2019.
-
Abstract
- Macrophage infiltration is associated with unfavorable kidney graft outcome in protocol biopsies, but few studies have evaluated its impact on clinical practice. We therefore prospectively evaluated 37 kidney transplant recipients (KTRs) who underwent kidney biopsy due to slight increases in serum creatinine, or mild proteinuria (>0.3 g/24 hr), in the first post-transplant year. Banff score, CD68+ count (score 0-3) by immunohistochemistry, and 1-year DSA were assessed. DGF was reported in 10 (27%) patients, 6 (16%) had normal biopsy, 7 (19%) borderline lesions, 13 (35%) IFTA, and 11 (30%) other lesions. Fifteen KTRs had grade 3 CD68+ infiltration, and 47% developed de novo DSA. During a 6.2 ± 2.7 year follow-up, four patients (11%) suffered from biopsy-proven T-cell rejection, 17 KTRs (46%) lost their graft (12 in the grade 3 CD68+ group). Graft survival was lower in KTRs with grade 3 CD68+ infiltration (P = 0.0074; log-rank test). Grade 3 CD68+ infiltrate was an independent predictor of graft loss (HR 5.41, 95% CI 1.74-16.8; P = 0.003), together with more severe graft dysfunction at biopsy (HR 6.41, 95% CI 2.57-16; P
- Subjects :
- Adult
Graft Rejection
Male
medicine.medical_specialty
Adolescent
Urology
Mild proteinuria
clinical outcome
kidney transplantation
chemistry.chemical_compound
Young Adult
graft biopsy
Risk Factors
Biopsy
medicine
Humans
Longitudinal Studies
Prospective Studies
Kidney transplantation
interstitial macrophage infiltration
Aged
Transplantation
Kidney
Creatinine
medicine.diagnostic_test
CD68
business.industry
Incidence
Macrophages
Graft Survival
Middle Aged
medicine.disease
Prognosis
medicine.anatomical_structure
Kidney Tubules
chemistry
Italy
Immunohistochemistry
Female
Primary Graft Dysfunction
business
Infiltration (medical)
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....4e3bd096171a025b39924469fb952553