Histologic Findings One Year After Positive Crossmatch or ABO Blood Group Incompatible Living Donor Kidney Transplantation
| Autor: | James M. Gloor, Joseph P. Grande, David J. Rea, Fernando G. Cosio, Hani M. Wadei, Donna J. Lager, Mark D. Stegall, S. B. Moore, Jeffrey L. Winters, Steven R. DeGoey |
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| Rok vydání: | 2006 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty Time Factors Biopsy Urinary system Urology ABO Blood-Group System ABO blood group system Living Donors Humans Immunology and Allergy Medicine Pharmacology (medical) Organ donation Kidney transplantation Transplantation Kidney medicine.diagnostic_test business.industry Graft Survival Complement C4 Transplant glomerulopathy Odds ratio Middle Aged medicine.disease Kidney Transplantation Surgery medicine.anatomical_structure Blood Group Incompatibility Female business Follow-Up Studies |
| Zdroj: | American Journal of Transplantation. 6:1841-1847 |
| ISSN: | 1600-6135 |
| Popis: | Recent protocols have allowed successful positive crossmatch (+XM) and ABO incompatible (ABOI) kidney transplantation, although their long-term outcome is not clear. To begin to assess this issue we compared protocol biopsies performed 12 months posttransplant in 37 +XM, 24 ABOI and 198 conventional allografts. Although the majority in all three groups had only minimal histologic changes, transplant glomerulopathy (TG) was significantly increased in +XM (22% vs. 13% ABOI vs. 8% conventional, p = 0.015), and correlated with prior humoral rejection (HR) by multivariate analysis (odds ratio 17.5, p < or = 0.0001). Patients with a prior history of HR also had a significant increase in interstitial fibrosis (No HR 54% vs. HR 86%, p = 0.045). In the absence of HR no difference in histologic changes was seen between groups, although all three groups had a demonstrable mild increase in interstitial fibrosis from biopsies performed at the time of transplant. Thus, although HR is associated with an increase in TG, in its absence allograft histology is similar in +XM, ABOI and conventional allografts 1 year posttransplant. |
| Databáze: | OpenAIRE |
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