Rejection-associated Phenotype of De Novo Thrombotic Microangiopathy Represents a Risk for Premature Graft Loss

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F21%3A00081712" target="_blank" >RIV/00023001:_____/21:00081712 - isvavai.cz</a>

Alternative codes found

RIV/00209775:_____/21:N0000021 RIV/00669806:_____/21:10433196 RIV/00843989:_____/21:E0109219 RIV/00216208:11140/21:10433196 and 5 more

Result on the web

<a href="https://journals.lww.com/transplantationdirect/Fulltext/2021/11000/Rejection_associated_Phenotype_of_De_Novo.8.aspx" target="_blank" >https://journals.lww.com/transplantationdirect/Fulltext/2021/11000/Rejection_associated_Phenotype_of_De_Novo.8.aspx</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1097/TXD.0000000000001239" target="_blank" >10.1097/TXD.0000000000001239</a>

Result language

angličtina

Original language name

Rejection-associated Phenotype of De Novo Thrombotic Microangiopathy Represents a Risk for Premature Graft Loss

Original language description

Background. Thrombotic microangiopathy (TMA) significantly affects kidney graft survival, but its pathophysiology remains poorly understood. Methods. In this multicenter, retrospective, case-control paired study designed to control for donor-associated risks, we assessed the recipients&apos; risk factors for de novo TMA development and its effects on graft survival. The study group consists of patients with TMA found in case biopsies from 2000 to 2019 (n = 93), and the control group consists of recipients of paired kidney grafts (n = 93). Graft follow-up was initiated at the time of TMA diagnosis and at the same time in the corresponding paired kidney graft. Results. The TMA group displayed higher peak panel-reactive antibodies, more frequent retransplantation status, and longer cold ischemia time in univariable analysis. In the multivariable regression model, longer cold ischemia times (odds ratio, 1.18; 95% confidence interval [CI], 1.01-1.39; P = 0.043) and higher peak pretransplant panel-reactive antibodies (odds ratio, 1.03; 95% CI, 1.01-1.06; P = 0.005) were found to be associated with increased risk of de novo TMA. The risk of graft failure was higher in the TMA group at 5 y (hazard ratio [HR], 3.99; 95% CI, 2.04-7.84; P &lt; 0.0001). Concomitant rejection significantly affected graft prognosis at 5 y (HR, 6.36; 95% CI, 2.92-13.87; P &lt; 0.001). De novo TMA associated with the active antibody-mediated rejection was associated with higher risk of graft failure at 5 y (HR, 3.43; 95% CI, 1.69-6.98; P &lt; 0.001) compared with other TMA. Conclusions. Longer cold ischemia and allosensitization play a role in de novo TMA development, whereas TMA as a part of active antibody-mediated rejection was associated with the highest risk for premature graft loss.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30217 - Urology and nephrology

Project

Result was created during the realization of more than one project. More information in the Projects tab.

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)<br>I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Transplantation Direct

ISSN

2373-8731

e-ISSN

—

Volume of the periodical

7

Issue of the periodical within the volume

11

Country of publishing house

US - UNITED STATES

Number of pages

7

Pages from-to

"art. no. e779"

UT code for WoS article

000709925500001

EID of the result in the Scopus database

2-s2.0-85126631453