In:
Clinical Transplantation, Wiley, Vol. 30, No. 8 ( 2016-08), p. 872-879
Abstract:
The clinical results of ABO ‐incompatible ( ABO i) and ABO ‐compatible ( ABO c) kidney transplantation ( KT ) are similar. Protocol kidney biopsies ( PKB ) of ABO i transplant recipients show positivity for C 4d without evidence of antibody‐mediated rejection ( ABMR ), but little is known about the histologic progression. Method We evaluated histologic parameters in PKB at 12 months and also compared clinical outcome at 1 year. This is a prospective observational study conducted between 2009 and 2013. We performed 146/30 ABO c/ ABO i consecutive living‐donor KT with PKB as well as additional indication biopsies. In the ABO i group, the desensitization protocol consisted of rituximab, plasma exchange or immunoadsorption, and immunoglobulins. Results In indication biopsies during the first year, T ‐cell‐mediated rejection B anff ≥immunoadsorption was 8.2% vs 6.7% ( P =.561) and ABMR 4.8% vs 13.3% ( P =.095). At 1 year, PKB ( ABO c/ ABO i) showed differences in borderline rejection lesions (6.8% vs 23.3% [ P =.012]) and in C4d positivity in the ABO i group ( P =.001). Interstitial fibrosis and tubular atrophy ( IFTA ) lesions ( ABO c/ ABO i) were 68.4% vs 63.2% ( P =.348). Transplant glomerulopathy was 0.7% vs 3.3% ( P =.373) at 1 year. Conclusions Our PKB ABO i series shows at 1 year more borderline lesions independent of ABO titers, HLA incompatibility, and the presence of antidonor antibody, but do not show more IFTA nor transplant glomerulopathy. No clinical differences were observed between ABO i and ABO transplants.
Type of Medium:
Online Resource
ISSN:
0902-0063
,
1399-0012
DOI:
10.1111/ctr.2016.30.issue-8
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2739458-X
detail.hit.zdb_id:
2004801-4