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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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. |
doi_str_mv | 10.1371/journal.pone.0256898 |
format | Article |
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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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0256898</identifier><identifier>PMID: 34478461</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2021-09, Vol.16 (9), p.e0256898-e0256898</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Kwon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Kwon et al 2021 Kwon et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c630t-a931605fbb2de2944d0ed5aab7b0e01515a6743adcbccdfc94d66c17aed2e4a93</citedby><cites>FETCH-LOGICAL-c630t-a931605fbb2de2944d0ed5aab7b0e01515a6743adcbccdfc94d66c17aed2e4a93</cites><orcidid>0000-0002-1894-1381</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415619/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415619/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids></links><search><creatorcontrib>Kwon, Hyunwook</creatorcontrib><creatorcontrib>Kim, Young Hoon</creatorcontrib><creatorcontrib>Ko, Youngmin</creatorcontrib><creatorcontrib>Lim, Seong Jun</creatorcontrib><creatorcontrib>Jung, Joo Hee</creatorcontrib><creatorcontrib>Baek, Chung Hee</creatorcontrib><creatorcontrib>Kim, Hyosang</creatorcontrib><creatorcontrib>Park, Su-Kil</creatorcontrib><creatorcontrib>Shin, Sung</creatorcontrib><creatorcontrib>Cho, Yong-Pil</creatorcontrib><title>Pure T-cell mediated rejection following kidney transplant according to response to treatment</title><title>PloS one</title><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.</description><subject>Antibodies</subject><subject>Biology and Life Sciences</subject><subject>Biopsy</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Glomerular filtration rate</subject><subject>Graft rejection</subject><subject>Grafting</subject><subject>Grafts</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Informed consent</subject><subject>Internal medicine</subject><subject>Kidney transplantation</subject><subject>Kidney transplants</subject><subject>Kidneys</subject><subject>Lymphocytes T</subject><subject>Medical schools</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Nephrology</subject><subject>Pancreas</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Rejection</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>T cells</subject><subject>Transplantation</subject><subject>Transplants & 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T-cell mediated rejection following kidney transplant according to response to treatment</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c630t-a931605fbb2de2944d0ed5aab7b0e01515a6743adcbccdfc94d66c17aed2e4a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antibodies</topic><topic>Biology and Life Sciences</topic><topic>Biopsy</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Glomerular filtration rate</topic><topic>Graft rejection</topic><topic>Grafting</topic><topic>Grafts</topic><topic>Health aspects</topic><topic>Health risks</topic><topic>Informed consent</topic><topic>Internal medicine</topic><topic>Kidney transplantation</topic><topic>Kidney transplants</topic><topic>Kidneys</topic><topic>Lymphocytes T</topic><topic>Medical schools</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Nephrology</topic><topic>Pancreas</topic><topic>Patients</topic><topic>Physical Sciences</topic><topic>Rejection</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>T cells</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kwon, Hyunwook</creatorcontrib><creatorcontrib>Kim, Young Hoon</creatorcontrib><creatorcontrib>Ko, Youngmin</creatorcontrib><creatorcontrib>Lim, Seong Jun</creatorcontrib><creatorcontrib>Jung, Joo Hee</creatorcontrib><creatorcontrib>Baek, Chung Hee</creatorcontrib><creatorcontrib>Kim, Hyosang</creatorcontrib><creatorcontrib>Park, Su-Kil</creatorcontrib><creatorcontrib>Shin, Sung</creatorcontrib><creatorcontrib>Cho, 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one</jtitle><date>2021-09-03</date><risdate>2021</risdate><volume>16</volume><issue>9</issue><spage>e0256898</spage><epage>e0256898</epage><pages>e0256898-e0256898</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34478461</pmid><doi>10.1371/journal.pone.0256898</doi><tpages>e0256898</tpages><orcidid>https://orcid.org/0000-0002-1894-1381</orcidid><oa>free_for_read</oa></addata></record> |
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source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
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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