Pure T-cell mediated rejection following kidney transplant according to response to treatment

The focus of studies on kidney transplantation (KT) has largely shifted from T-cell mediated rejection (TCMR) to antibody-mediated rejection (ABMR). However, there are still cases of pure acute TCMR in histological reports, even after a long time following transplant. We thus evaluated the impact of...

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Veröffentlicht in:PloS one 2021-09, Vol.16 (9), p.e0256898-e0256898
Hauptverfasser: Kwon, Hyunwook, Kim, Young Hoon, Ko, Youngmin, Lim, Seong Jun, Jung, Joo Hee, Baek, Chung Hee, Kim, Hyosang, Park, Su-Kil, Shin, Sung, Cho, Yong-Pil
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container_issue 9
container_start_page e0256898
container_title PloS one
container_volume 16
creator Kwon, Hyunwook
Kim, Young Hoon
Ko, Youngmin
Lim, Seong Jun
Jung, Joo Hee
Baek, Chung Hee
Kim, Hyosang
Park, Su-Kil
Shin, Sung
Cho, Yong-Pil
description The focus of studies on kidney transplantation (KT) has largely shifted from T-cell mediated rejection (TCMR) to antibody-mediated rejection (ABMR). However, there are still cases of pure acute TCMR in histological reports, even after a long time following transplant. We thus evaluated the impact of pure TCMR on graft survival (GS) according to treatment response. We also performed molecular diagnosis using a molecular microscope diagnostic system on a separate group of 23 patients. A total of 63 patients were divided into non-responders (N = 22) and responders (N = 44). Non-response to rejection treatment was significantly associated with the following factors: glomerular filtration rate (GFR) at biopsy, ΔGFR, TCMR within one year, t score, and IF/TA score. We also found that non-responder vs. responder (OR = 3.31; P = 0.036) and lower GFR at biopsy (OR = 0.56; P = 0.026) were independent risk factors of graft failure. The responders had a significantly superior overall GS rate compared with the non-responders ( P = 0.004). Molecular assessment showed a good correlation with histologic diagnosis in ABMR, but not in TCMR. Solitary TCMR was a significant risk factor of graft failure in patients who did not respond to rejection treatment.
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However, there are still cases of pure acute TCMR in histological reports, even after a long time following transplant. We thus evaluated the impact of pure TCMR on graft survival (GS) according to treatment response. We also performed molecular diagnosis using a molecular microscope diagnostic system on a separate group of 23 patients. A total of 63 patients were divided into non-responders (N = 22) and responders (N = 44). Non-response to rejection treatment was significantly associated with the following factors: glomerular filtration rate (GFR) at biopsy, ΔGFR, TCMR within one year, t score, and IF/TA score. We also found that non-responder vs. responder (OR = 3.31; P = 0.036) and lower GFR at biopsy (OR = 0.56; P = 0.026) were independent risk factors of graft failure. The responders had a significantly superior overall GS rate compared with the non-responders ( P = 0.004). Molecular assessment showed a good correlation with histologic diagnosis in ABMR, but not in TCMR. 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subjects Antibodies
Biology and Life Sciences
Biopsy
Diagnosis
Diagnostic systems
Glomerular filtration rate
Graft rejection
Grafting
Grafts
Health aspects
Health risks
Informed consent
Internal medicine
Kidney transplantation
Kidney transplants
Kidneys
Lymphocytes T
Medical schools
Medicine
Medicine and Health Sciences
Nephrology
Pancreas
Patients
Physical Sciences
Rejection
Risk analysis
Risk factors
Surgery
T cells
Transplantation
Transplants & implants
title Pure T-cell mediated rejection following kidney transplant according to response to treatment
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