Acute cellular rejection with isolated v‐lesions is not associated with more favorable outcomes than vascular rejection with more tubulointerstitial inflammations. (11th March 2014)

• Record Type: Journal Article
• Authors: Wu, K. Y.; Budde, K.; Schmidt, D.; Neumayer, H. H.; Rudolph, B.
• Is Part Of: Clinical transplantation. Volume 28:Number 4(2014:Jul./Aug.)
• Page Start: 410
• Page End: 418
• Publication Date: 2014-03-11
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12333
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12333-abs-0001"> <title>Abstract</title> <sec id="ctr12333-sec-0001" sec-type="section"> <title>Background</title> <p>The impact of isolated v‐lesions on clinical outcome in biopsies with acute cellular rejection (ACR) is unclear.</p> </sec> <sec id="ctr12333-sec-0002" sec-type="section"> <title>Methods</title> <p>Two hundred and sixty‐five biopsies showing the highest ACR severity for each patient were recruited and classified into four groups: (i) acute interstitial rejection (AIR) I with minimal tubulointerstitial inflammation (TI), (ii) AIR II with intensive TI, (iii) acute vascular rejection (AVR) I with minimal TI, and (iv) AVR II with intensive TI.</p> </sec> <sec id="ctr12333-sec-0003" sec-type="section"> <title>Results</title> <p>The complete reversal rates of AIR I and AIR II groups were marginally higher than AVR I and AVR II groups (p = 0.16). At eight yr of transplantation, the death‐censored graft survival (DCGS) rate of AIR I group (93.3%) was significantly higher compared with the AVR I (72.7%) or AVR II (72.9%) group. AVR I group had a similar DCGS rate with AVR II group (72.7% vs. 74.1%), whereas AVR with v1‐lesion showed significantly higher graft survival (GS) rate than those with v2‐lesion (70.2% vs. 45.5%). The t‐lesion of AIR and v‐lesion of AVR group were associated with graft loss.</p> </sec> <sec id="ctr12333-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The extent of TI is non‐specifically associated with graft loss in biopsies with AVR; the higher grade v‐lesion predicts the lower complete reversal rate and poorer long‐term graft survival.</p> </sec> </abstract>