Intimal Arteritis and Microvascular Inflammation Are Associated With Inferior Kidney Graft Outcome, Regardless of Donor-Specific Antibodies

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F21%3A00081850" target="_blank" >RIV/00023001:_____/21:00081850 - isvavai.cz</a>

Result on the web

<a href="https://www.frontiersin.org/articles/10.3389/fmed.2021.781206/full" target="_blank" >https://www.frontiersin.org/articles/10.3389/fmed.2021.781206/full</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3389/fmed.2021.781206" target="_blank" >10.3389/fmed.2021.781206</a>

Result language

angličtina

Original language name

Intimal Arteritis and Microvascular Inflammation Are Associated With Inferior Kidney Graft Outcome, Regardless of Donor-Specific Antibodies

Original language description

Background: The prognostic role of intimal arteritis of kidney allografts in donor-specific antibody negative (DSA-) antibody-mediated rejection (ABMR) remains unclear. Methods: Seventy-two out of 881 patients wgo had undergone kidney transplantation from 2014 to 2017 exhibited intimal arteritis in biopsies performed during the first 12 months. In 26 DSA negative cases, the intimal arteritis was accompanied by tubulointerstitial inflammation as part of T cell-mediated vascular rejection (TCMRV, N = 26); intimal arteritis along with microvascular inflammation occured in 29 DSA negative (ABMRV/DSA-) and 19 DSA positive cases (ABMRV. DSA+, N = 17). In 60 (83%) patients with intimal arteritis, the surveillance biopsies after antirejection therapy were performed. Hundred and two patients with non-vascular ABMR with DSA (ABMR/DSA+, N = 55) and without DSA (ABMR/DSA-, N = 47) served as controls. Time to transplant glomerulopathy (TG) and graft failure were the study endpoints. Results: Transplant glomerulopathy-free survival at 36 months was 100% in TCMRV, 85% in ABMRV/DSA+ (log rank p&lt;0.001). Death-censored graft survival at 36 months was 98% in ABMR/DSA-, 96% in TCMRV, 86% in ABMRV/DSA-, 79% in ABMR/DSA+, and 64% in ABMR/DSA+ group (log rank p=0.001). In surveillance biopsies, the resolution of rejection was found in 19 (90%) TCMRV, 14 (58%) ABMRV/DSA-, and only 4 (27%) ABMRV/DSA+ patients (p=0.006). In the multivariable model, intimal arteries as part of ABMR represented a significant risk for TG development (HR 2.1, 95% Cl 1.2-3.8; p=0.012) regardless of DSA status but not for graft failure at 36 months. Conclusions: Intimal arteries as part of ABMR represented a risk for early development of TG regardless of the presence or absence of DSA. Intimal arteritis in DSA positive ABMR represented the high-risk phenotype.

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

30213 - Transplantation

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

Frontiers in medicine [online]

ISSN

2296-858X

e-ISSN

—

Volume of the periodical

8

Issue of the periodical within the volume

08 December

Country of publishing house

CH - SWITZERLAND

Number of pages

10

Pages from-to

"art. no. 781206"

UT code for WoS article

000732482400001

EID of the result in the Scopus database

2-s2.0-85121645111