Long-term immunological outcomes of early subclinical inflammation on surveillance kidney allograft biopsies

医学 亚临床感染 活检 危险系数 内科学 肾功能 肾移植 优势比 队列 外科 置信区间
作者
Rajil Mehta,Ivy Melgarejo,Vignesh Viswanathan,Xingyu Zhang,Matthew Pittappilly,Parmjeet Randhawa,Chethan Puttarajappa,Puneet Sood,Christine Wu,Akhil Sharma,Michele Molinari,Sundaram Hariharan
出处
期刊:Kidney International [Elsevier]
卷期号:102 (6): 1371-1381 被引量:17
标识
DOI:10.1016/j.kint.2022.07.030
摘要

Abstract

The long-term impact of early subclinical inflammation (SCI) through surveillance biopsy has not been well studied. To do this, we recruited a prospective observational cohort that included 1000 sequential patients who received a kidney transplant from 2013-2017 at our center. A total of 586 patients who underwent a surveillance biopsy in their first-year post-transplant were included after excluding those with clinical rejections, and those who were unable to undergo a surveillance biopsy. Patients were classified based on their biopsy findings: 282 with NSI (No Significant Inflammation) and 304 with SCI-T (SCI and Tubulitis) which was further subdivided into 182 with SC-BLR (Subclinical Borderline Changes) and 122 with SC-TCMR (Subclinical T Cell Mediated Rejection, Banff 2019 classification of 1A or more). We followed the clinical and immunological events including Clinical Biopsy Proven Acute Rejection [C-BPAR], long-term kidney function and death censored graft loss over a median follow-up of five years. Episodes of C-BPAR were noted at a median of two years post-transplant. Adjusted odds of having a subsequent C-BPAR was significantly higher in the SCI-T group [SC-BLR and SC-TCMR] compared to NSI 3.8 (2.1-7.5). The adjusted hazard for death censored graft loss was significantly higher with SCI-T compared to NSI [1.99 (1.04-3.84)]. Overall, SCI detected through surveillance biopsy within the first year post-transplant is a harbinger for subsequent immunological events and is associated with a significantly greater hazard for subsequent C-BPAR and death censored graft loss. Thus, our study highlights the need for identifying patients with SCI through surveillance biopsy and develop strategies to prevent further alloimmune injuries.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
1秒前
1秒前
2秒前
2秒前
2秒前
陈一一完成签到 ,获得积分10
2秒前
mmgf完成签到,获得积分10
3秒前
欢呼煎蛋发布了新的文献求助10
3秒前
3秒前
4秒前
剑舞人间发布了新的文献求助30
4秒前
4秒前
小蘑菇应助dracovu采纳,获得10
5秒前
李辉发布了新的文献求助10
6秒前
misshe发布了新的文献求助10
7秒前
懒得起名发布了新的文献求助10
7秒前
大力的诗蕾完成签到,获得积分10
7秒前
香蕉招牌发布了新的文献求助20
7秒前
欢呼煎蛋完成签到,获得积分10
8秒前
8秒前
doby发布了新的文献求助10
8秒前
lofads完成签到,获得积分10
8秒前
Carlos发布了新的文献求助50
8秒前
不倦应助guugen采纳,获得10
9秒前
syy完成签到,获得积分10
10秒前
3301发布了新的文献求助10
11秒前
11秒前
长情的不言完成签到,获得积分10
12秒前
12秒前
13秒前
Lucas应助呆萌的太阳采纳,获得10
13秒前
doby完成签到,获得积分10
14秒前
14秒前
研友_菲完成签到,获得积分10
14秒前
14秒前
Leach完成签到 ,获得积分10
15秒前
Kalimba完成签到,获得积分10
15秒前
李辉完成签到,获得积分10
15秒前
超帅的访云完成签到,获得积分10
15秒前
高分求助中
Comparative Anatomy of the Vertebrates 9th 3000
Continuum Thermodynamics and Material Modelling 3000
Production Logging: Theoretical and Interpretive Elements 2700
Les Mantodea de Guyane Insecta, Polyneoptera 1000
Structural Load Modelling and Combination for Performance and Safety Evaluation 1000
Conference Record, IAS Annual Meeting 1977 820
England and the Discovery of America, 1481-1620 600
热门求助领域 (近24小时)
化学 材料科学 生物 医学 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 量子力学 光电子学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3571929
求助须知:如何正确求助?哪些是违规求助? 3142327
关于积分的说明 9446826
捐赠科研通 2843700
什么是DOI,文献DOI怎么找? 1563001
邀请新用户注册赠送积分活动 731530
科研通“疑难数据库(出版商)”最低求助积分说明 718557