Differences in Chronic Intragraft Inflammation Between Positive Crossmatch and ABO-Incompatible Kidney Transplantation
BACKGROUNDABO-incompatible kidney transplantations (ABOiKTxs) seem to have better long-term outcomes than positive crossmatch kidney transplantations (+XMKTxs). METHODSThis study aimed to assess the differences in chronic injury on histologic findings on 1- and 5-year surveillance biopsies and the c...
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| Veröffentlicht in: | Transplantation 2014-11, Vol.98 (10), p.1089-1096 |
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| creator | Bentall, Andrew Herrera, Loren P Cornell, Lynn D Gonzales, Manuel A Moreno Dean, Patrick G Park, Walter D Gandhi, Manish J Winters, Jeffrey L Stegall, Mark D |
| description | BACKGROUNDABO-incompatible kidney transplantations (ABOiKTxs) seem to have better long-term outcomes than positive crossmatch kidney transplantations (+XMKTxs).
METHODSThis study aimed to assess the differences in chronic injury on histologic findings on 1- and 5-year surveillance biopsies and the clinical outcomes in living-donor kidney transplantations performed between May 1999 and November 2006 including 102 +XMKTxs, 73 ABOiKTxs, and 652 conventional KTxs.
RESULTSAlthough 5-year patient survival was similar between groups, graft loss between 1 and 5 years was similar in ABOiKTx (2.6% per year) and conventional KTx (1.7% per yr), and both were lower than that of +XMKTx (5.8% per year). At 5 years, renal function was similar in ABOiKTx and conventional KTx, and both were higher than that of +XMKTx, which had higher rates of inflammation and chronic glomerulopathy on both 1- and 5-year biopsies. Despite having evidence of less chronic injury, ABOiKTx showed a higher rate of intragraft complement activation (C4d deposition) at 5 years compared with +XMKTx (77.8% vs. 18.9%, P |
| doi_str_mv | 10.1097/TP.0000000000000188 |
| format | Article |
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METHODSThis study aimed to assess the differences in chronic injury on histologic findings on 1- and 5-year surveillance biopsies and the clinical outcomes in living-donor kidney transplantations performed between May 1999 and November 2006 including 102 +XMKTxs, 73 ABOiKTxs, and 652 conventional KTxs.
RESULTSAlthough 5-year patient survival was similar between groups, graft loss between 1 and 5 years was similar in ABOiKTx (2.6% per year) and conventional KTx (1.7% per yr), and both were lower than that of +XMKTx (5.8% per year). At 5 years, renal function was similar in ABOiKTx and conventional KTx, and both were higher than that of +XMKTx, which had higher rates of inflammation and chronic glomerulopathy on both 1- and 5-year biopsies. Despite having evidence of less chronic injury, ABOiKTx showed a higher rate of intragraft complement activation (C4d deposition) at 5 years compared with +XMKTx (77.8% vs. 18.9%, P<0.001).
CONCLUSIONThese data suggest that +XMKTxs have high rates of chronic inflammation at 1 and 5 years after transplantation, which may explain the higher rates of graft loss and lower renal function compared with other factors such as anti–donor antibody or intragraft complement deposition.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/TP.0000000000000188</identifier><identifier>PMID: 24911035</identifier><language>eng</language><publisher>United States: by Lippincott Williams & Wilkins</publisher><subject>ABO Blood-Group System ; Adult ; Aged ; Female ; Graft Rejection - etiology ; Graft Rejection - immunology ; Graft Rejection - pathology ; Graft Survival - immunology ; Histocompatibility Testing ; Humans ; Inflammation - etiology ; Inflammation - immunology ; Inflammation - pathology ; Isoantibodies - blood ; Kidney - immunology ; Kidney - injuries ; Kidney - pathology ; Kidney Transplantation - adverse effects ; Kidney Transplantation - mortality ; Living Donors ; Male ; Middle Aged ; Survival Analysis ; Time Factors ; Treatment Outcome</subject><ispartof>Transplantation, 2014-11, Vol.98 (10), p.1089-1096</ispartof><rights>2014 by Lippincott Williams & Wilkins</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5678-d20b6dcdb8a9b77e35c6926840c4460510a47e4f8085768c0a783fd42b5aee383</citedby><cites>FETCH-LOGICAL-c5678-d20b6dcdb8a9b77e35c6926840c4460510a47e4f8085768c0a783fd42b5aee383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24911035$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bentall, Andrew</creatorcontrib><creatorcontrib>Herrera, Loren P</creatorcontrib><creatorcontrib>Cornell, Lynn D</creatorcontrib><creatorcontrib>Gonzales, Manuel A Moreno</creatorcontrib><creatorcontrib>Dean, Patrick G</creatorcontrib><creatorcontrib>Park, Walter D</creatorcontrib><creatorcontrib>Gandhi, Manish J</creatorcontrib><creatorcontrib>Winters, Jeffrey L</creatorcontrib><creatorcontrib>Stegall, Mark D</creatorcontrib><title>Differences in Chronic Intragraft Inflammation Between Positive Crossmatch and ABO-Incompatible Kidney Transplantation</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>BACKGROUNDABO-incompatible kidney transplantations (ABOiKTxs) seem to have better long-term outcomes than positive crossmatch kidney transplantations (+XMKTxs).
METHODSThis study aimed to assess the differences in chronic injury on histologic findings on 1- and 5-year surveillance biopsies and the clinical outcomes in living-donor kidney transplantations performed between May 1999 and November 2006 including 102 +XMKTxs, 73 ABOiKTxs, and 652 conventional KTxs.
RESULTSAlthough 5-year patient survival was similar between groups, graft loss between 1 and 5 years was similar in ABOiKTx (2.6% per year) and conventional KTx (1.7% per yr), and both were lower than that of +XMKTx (5.8% per year). At 5 years, renal function was similar in ABOiKTx and conventional KTx, and both were higher than that of +XMKTx, which had higher rates of inflammation and chronic glomerulopathy on both 1- and 5-year biopsies. Despite having evidence of less chronic injury, ABOiKTx showed a higher rate of intragraft complement activation (C4d deposition) at 5 years compared with +XMKTx (77.8% vs. 18.9%, P<0.001).
CONCLUSIONThese data suggest that +XMKTxs have high rates of chronic inflammation at 1 and 5 years after transplantation, which may explain the higher rates of graft loss and lower renal function compared with other factors such as anti–donor antibody or intragraft complement deposition.</description><subject>ABO Blood-Group System</subject><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Graft Rejection - etiology</subject><subject>Graft Rejection - immunology</subject><subject>Graft Rejection - pathology</subject><subject>Graft Survival - immunology</subject><subject>Histocompatibility Testing</subject><subject>Humans</subject><subject>Inflammation - etiology</subject><subject>Inflammation - immunology</subject><subject>Inflammation - pathology</subject><subject>Isoantibodies - blood</subject><subject>Kidney - immunology</subject><subject>Kidney - injuries</subject><subject>Kidney - pathology</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Kidney Transplantation - mortality</subject><subject>Living Donors</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1P3DAQhi1UBFvaX1Cp8rGX0HH8mSNsS1kViT0s58hxJl23ibO1vaz49wQWqooDzGVGmmfemdFLyCcGpwwq_XW1PIX_gxlzQGZMclEoMPCOzAAEKxjn-pi8T-n3xEiu9RE5LkXFGHA5I7fffNdhxOAwUR_ofB3H4B1dhBztr2i7PJVdb4fBZj8Geo55hxjockw--1uk8zimNDXdmtrQ0rPz62IR3DhsJr7pkf70bcA7uoo2pE1vQ37U-UAOO9sn_PiUT8jNxffV_LK4uv6xmJ9dFU4qbYq2hEa1rm2MrRqtkUunqlIZAU4IBZKBFRpFZ8BIrYwDqw3vWlE20iJyw0_Il73uJo5_t5hyPfjksJ8OwXGbaqahYkoZUG-jqlRMSVPyCeV71D08H7GrN9EPNt7VDOoHb-rVsn7pzTT1-WnBthmw_TfzbMYE6D2wG_uMMf3ptzuM9Rptn9evSt8DpDKa1g</recordid><startdate>20141127</startdate><enddate>20141127</enddate><creator>Bentall, Andrew</creator><creator>Herrera, Loren P</creator><creator>Cornell, Lynn D</creator><creator>Gonzales, Manuel A Moreno</creator><creator>Dean, Patrick G</creator><creator>Park, Walter D</creator><creator>Gandhi, Manish J</creator><creator>Winters, Jeffrey L</creator><creator>Stegall, Mark D</creator><general>by Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20141127</creationdate><title>Differences in Chronic Intragraft Inflammation Between Positive Crossmatch and ABO-Incompatible Kidney Transplantation</title><author>Bentall, Andrew ; Herrera, Loren P ; Cornell, Lynn D ; Gonzales, Manuel A Moreno ; Dean, Patrick G ; Park, Walter D ; Gandhi, Manish J ; Winters, Jeffrey L ; Stegall, Mark D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5678-d20b6dcdb8a9b77e35c6926840c4460510a47e4f8085768c0a783fd42b5aee383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>ABO Blood-Group System</topic><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Graft Rejection - etiology</topic><topic>Graft Rejection - immunology</topic><topic>Graft Rejection - pathology</topic><topic>Graft Survival - immunology</topic><topic>Histocompatibility Testing</topic><topic>Humans</topic><topic>Inflammation - etiology</topic><topic>Inflammation - immunology</topic><topic>Inflammation - pathology</topic><topic>Isoantibodies - blood</topic><topic>Kidney - immunology</topic><topic>Kidney - injuries</topic><topic>Kidney - pathology</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Kidney Transplantation - mortality</topic><topic>Living Donors</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bentall, Andrew</creatorcontrib><creatorcontrib>Herrera, Loren P</creatorcontrib><creatorcontrib>Cornell, Lynn D</creatorcontrib><creatorcontrib>Gonzales, Manuel A Moreno</creatorcontrib><creatorcontrib>Dean, Patrick G</creatorcontrib><creatorcontrib>Park, Walter D</creatorcontrib><creatorcontrib>Gandhi, Manish J</creatorcontrib><creatorcontrib>Winters, Jeffrey L</creatorcontrib><creatorcontrib>Stegall, Mark D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bentall, Andrew</au><au>Herrera, Loren P</au><au>Cornell, Lynn D</au><au>Gonzales, Manuel A Moreno</au><au>Dean, Patrick G</au><au>Park, Walter D</au><au>Gandhi, Manish J</au><au>Winters, Jeffrey L</au><au>Stegall, Mark D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differences in Chronic Intragraft Inflammation Between Positive Crossmatch and ABO-Incompatible Kidney Transplantation</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2014-11-27</date><risdate>2014</risdate><volume>98</volume><issue>10</issue><spage>1089</spage><epage>1096</epage><pages>1089-1096</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><abstract>BACKGROUNDABO-incompatible kidney transplantations (ABOiKTxs) seem to have better long-term outcomes than positive crossmatch kidney transplantations (+XMKTxs).
METHODSThis study aimed to assess the differences in chronic injury on histologic findings on 1- and 5-year surveillance biopsies and the clinical outcomes in living-donor kidney transplantations performed between May 1999 and November 2006 including 102 +XMKTxs, 73 ABOiKTxs, and 652 conventional KTxs.
RESULTSAlthough 5-year patient survival was similar between groups, graft loss between 1 and 5 years was similar in ABOiKTx (2.6% per year) and conventional KTx (1.7% per yr), and both were lower than that of +XMKTx (5.8% per year). At 5 years, renal function was similar in ABOiKTx and conventional KTx, and both were higher than that of +XMKTx, which had higher rates of inflammation and chronic glomerulopathy on both 1- and 5-year biopsies. Despite having evidence of less chronic injury, ABOiKTx showed a higher rate of intragraft complement activation (C4d deposition) at 5 years compared with +XMKTx (77.8% vs. 18.9%, P<0.001).
CONCLUSIONThese data suggest that +XMKTxs have high rates of chronic inflammation at 1 and 5 years after transplantation, which may explain the higher rates of graft loss and lower renal function compared with other factors such as anti–donor antibody or intragraft complement deposition.</abstract><cop>United States</cop><pub>by Lippincott Williams & Wilkins</pub><pmid>24911035</pmid><doi>10.1097/TP.0000000000000188</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | ABO Blood-Group System Adult Aged Female Graft Rejection - etiology Graft Rejection - immunology Graft Rejection - pathology Graft Survival - immunology Histocompatibility Testing Humans Inflammation - etiology Inflammation - immunology Inflammation - pathology Isoantibodies - blood Kidney - immunology Kidney - injuries Kidney - pathology Kidney Transplantation - adverse effects Kidney Transplantation - mortality Living Donors Male Middle Aged Survival Analysis Time Factors Treatment Outcome |
| title | Differences in Chronic Intragraft Inflammation Between Positive Crossmatch and ABO-Incompatible Kidney Transplantation |
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