Biopsy findings after detection of de novo donor-specific antibodies in renal transplant recipients: a single center experience.
Biopsy findings after detection of de novo donor-specific antibodies in renal transplant recipients: a single center experience.
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DOI：
10.1007/s40620-021-01040-y
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发表时间：
2021-12
影响因子：
3.4
通讯作者：
Westhoff TH
中科院分区：
文献类型：
--
作者：
Waldecker CB;Zgoura P;Seibert FS;Gall S;Schenker P;Bauer F;Rohn B;Viebahn R;Babel N;Westhoff TH
新生供体特异性抗体（DSA）与抗体介导的排斥反应风险增加和同种异体移植物存活率大幅降低相关。我们假设，即使在没有蛋白尿和估计肾小球滤过率（eGFR）丢失的情况下，检测到DSA也应该提示活检。然而，没有蛋白尿或肾功能丧失的人群的数据很少，这是我们研究设计的主要新颖之处。新发DSA后活检结果的单中心回顾性分析。其中包括132名肾脏和胰肾移植受者。其中84例（63.6%）接受了同种异体移植物活检。活检时n = 50（59.5%）在过去12个月内蛋白/肌酐比值（PCR）为300 mg/g肌酐和/或eGFR损失≥10 ml/min，而40.5%没有。根据Banff标准诊断排斥反应。77例（91.7%）活检有排斥反应迹象（47.6%抗体介导排斥反应（ABMR）， 13.1%细胞性排斥反应，20.2%联合排斥反应，10.7%边缘性排斥反应）。在没有蛋白尿或eGFR丢失≥10 ml/min/a的受试者中（n = 34）， 29例（85.3%）出现排斥反应迹象（44.1%抗体介导（ABMR）， 14.7%细胞性，11.8%联合，14.7%交界性）。大多数新生DSA患者有排斥反应的组织学征象，即使没有蛋白尿和移植物功能恶化。因此，在发现新发DSA后常规进行同种异体移植物活检似乎是合理的。在线版本包含补充材料，可在10.1007/s40620-021-01040-y获得。
De novo donor-specific antibodies (DSA) are associated with an increased risk of antibody-mediated rejection and a substantial reduction of allograft survival. We hypothesized that detection of DSA should prompt a biopsy even in the absence of proteinuria and loss of estimated glomerular filtration rate (eGFR). However, data on a population without proteinuria or loss of kidney function is scant, and this is the main novelty of our study design. Single center retrospective analysis on biopsy findings after detection of de novo DSA. One-hundred-thirty-two kidney and pancreas-kidney transplant recipients were included. Eighty-four of these patients (63.6%) underwent allograft biopsy. At the time of biopsy n = 50 (59.5%) had a protein/creatinine ratio (PCR) > 300 mg/g creatinine and/or a loss of eGFR ≥ 10 ml/min in the previous 12 months, whereas 40.5% did not. Diagnosis of rejection was performed according to Banff criteria. Seventy-seven (91.7%) of the biopsies had signs of rejection (47.6% antibody mediated rejection (ABMR), 13.1% cellular, 20.2% combined, 10.7% borderline). Among subjects without proteinuria or loss of eGFR ≥ 10 ml/min/a (n = 34), 29 patients (85.3%) showed signs of rejection (44.1% antibody mediated (ABMR), 14.7% cellular, 11.8% combined, 14.7% borderline). The majority of subjects with de novo DSA have histological signs of rejection, even in the absence of proteinuria and deterioration of graft function. Thus, it appears reasonable to routinely perform an allograft biopsy after the detection of de novo DSA. The online version contains supplementary material available at 10.1007/s40620-021-01040-y.
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影响因子：
8.8
作者：
Wiebe, C.;Gibson, I. W.;Nickerson, P. W.
通讯作者：
Nickerson, P. W.
影响因子：
8.8
作者：
Nickerson, Peter W.
通讯作者：
Nickerson, Peter W.
DOI：
10.5114/kitp.2014.41932
发表时间：
2014-01-01
期刊：
KARDIOCHIRURGIA I TORAKOCHIRURGIA POLSKA
影响因子：
--
作者：
Zakliczynski, Michal;Nozynski, Jerzy;Zembala, Marian
通讯作者：
Zembala, Marian
影响因子：
6.2
作者：
Roufosse C;Simmonds N;Clahsen-van Groningen M;Haas M;Henriksen KJ;Horsfield C;Loupy A;Mengel M;Perkowska-Ptasińska A;Rabant M;Racusen LC;Solez K;Becker JU
通讯作者：
Becker JU
影响因子：
6.2
作者：
Pascual, M;Vallhonrat, H;Williams, WW
通讯作者：
Williams, WW