Treatment of chronic active T cell-mediated rejection after kidney transplantation : A retrospective cohort study of 37 transplants
© 2022 Asian Pacific Society of Nephrology..
AIM: Data on the treatment of chronic active T cell-mediated rejection (CA-TCMR) are scarce, and therapeutical strategies for CA-TCMR have not been established. We retrospectively evaluated the outcomes and effects of treatment on pathological and clinical findings in patients with CA-TCMR.
METHODS: This study comprised 37 patients who underwent kidney transplantation at our institute who were diagnosed with CA-TCMR between January 2018 and December 2020. Patients were followed until October 2021.
RESULTS: A total of 32 of the 37 patients were treated. During the observation period, two patients died (5%), and five patients developed allograft loss (13%). A univariate Cox proportional hazards model showed that indication biopsy, higher spot urine protein/creatinine ratio (UPCR) and Banff ci/ct scores were risk factors for allograft loss. Of the treated patients, 23 underwent follow-up biopsies. The Wilcoxon signed-rank test showed significant improvement in the Baff scores for "ti", "i-IFTA", "t" and "t-IFTA" after treatment. On pathology, 13 (57%) of the patients who underwent follow-up biopsy improved to "no evidence of rejection" or "borderline change." Assuming that improvement in pathology to "borderline change" or "no evidence of rejection" on follow-up biopsy indicates response to treatment, multivariate logistic analysis showed that lower UPCR was a predictive factor for response to treatment. No specific effect of treatment type was observed.
CONCLUSIONS: Our results indicate that treatment could improve the pathological findings in CA-TCMR.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Nephrology (Carlton, Vic.) - 27(2022), 7 vom: 01. Juli, Seite 632-638 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Noguchi, Hiroshi [VerfasserIn] |
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| Links: |
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| Themen: |
Chronic active T cell-mediated rejection |
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| Anmerkungen: |
Date Completed 10.06.2022 Date Revised 10.06.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/nep.14048 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM340073624 |
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| 100 | 1 | |a Noguchi, Hiroshi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Treatment of chronic active T cell-mediated rejection after kidney transplantation |b A retrospective cohort study of 37 transplants |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 Asian Pacific Society of Nephrology. | ||
| 520 | |a AIM: Data on the treatment of chronic active T cell-mediated rejection (CA-TCMR) are scarce, and therapeutical strategies for CA-TCMR have not been established. We retrospectively evaluated the outcomes and effects of treatment on pathological and clinical findings in patients with CA-TCMR | ||
| 520 | |a METHODS: This study comprised 37 patients who underwent kidney transplantation at our institute who were diagnosed with CA-TCMR between January 2018 and December 2020. Patients were followed until October 2021 | ||
| 520 | |a RESULTS: A total of 32 of the 37 patients were treated. During the observation period, two patients died (5%), and five patients developed allograft loss (13%). A univariate Cox proportional hazards model showed that indication biopsy, higher spot urine protein/creatinine ratio (UPCR) and Banff ci/ct scores were risk factors for allograft loss. Of the treated patients, 23 underwent follow-up biopsies. The Wilcoxon signed-rank test showed significant improvement in the Baff scores for "ti", "i-IFTA", "t" and "t-IFTA" after treatment. On pathology, 13 (57%) of the patients who underwent follow-up biopsy improved to "no evidence of rejection" or "borderline change." Assuming that improvement in pathology to "borderline change" or "no evidence of rejection" on follow-up biopsy indicates response to treatment, multivariate logistic analysis showed that lower UPCR was a predictive factor for response to treatment. No specific effect of treatment type was observed | ||
| 520 | |a CONCLUSIONS: Our results indicate that treatment could improve the pathological findings in CA-TCMR | ||
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| 650 | 4 | |a chronic active T cell-mediated rejection | |
| 650 | 4 | |a kidney transplantation | |
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| 700 | 1 | |a Matsukuma, Yuta |e verfasserin |4 aut | |
| 700 | 1 | |a Nakagawa, Kaneyasu |e verfasserin |4 aut | |
| 700 | 1 | |a Ueki, Kenji |e verfasserin |4 aut | |
| 700 | 1 | |a Tsuchimoto, Akihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Nakano, Toshiaki |e verfasserin |4 aut | |
| 700 | 1 | |a Sato, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Kaku, Keizo |e verfasserin |4 aut | |
| 700 | 1 | |a Okabe, Yasuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Nakamura, Masafumi |e verfasserin |4 aut | |
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