Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis
| Autor: | Erika Bracamonte, Machaiah Madhrira, M. M. Popovtzer, Irfan Moinuddin, Pradeep V. Kadambi, Bijin Thajudeen, Amy N. Sussman |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Pathology medicine.medical_treatment T cell 030232 urology & nephrology lcsh:Surgery Case Report 030230 surgery Gastroenterology Lesion 03 medical and health sciences 0302 clinical medicine Fibrosis Management of Technology and Innovation Internal medicine Biopsy medicine Arteritis Lead (electronics) Kidney medicine.diagnostic_test business.industry Immunosuppression lcsh:RD1-811 medicine.disease medicine.anatomical_structure medicine.symptom business |
| Zdroj: | Case Reports in Transplantation Case Reports in Transplantation, Vol 2016 (2016) |
| ISSN: | 2090-6943 |
| Popis: | Acute vascular rejection (AVR) is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection (AIR) and AVR is associated with a higher rate of graft loss than AIR. The prognosis and treatment of arteritis without tubulitis and interstitial inflammation (isolated v1 lesion) are still controversial. We report a case of a patient who had a biopsy of the kidney allograft for evaluation of slow graft function. The biopsy revealed an isolated v1 lesion. However, we chose not to augment immunosuppression. The patient’s kidney allograft function improved over time with close monitoring. Repeat biopsy a year later showed no evidence of endothelialitis and relatively unchanged fibrosis and no other abnormalities. Although it is suggested that most cases of isolated v1 lesions will respond to corticosteroids or T cell depleting therapies, some cases will improve with conservative management. Further studies are needed to determine which cases could be managed conservatively. |
| Databáze: | OpenAIRE |
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