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|Title:||Decreased kidney graft survival in low immunological risk patients showing inflammation in normal protocol biopsies|
Bestard Matamoros, Oriol
Grinyo Boira, Josep M.
Cruzado, Josep Ma.
|Publisher:||Public Library of Science (PLoS)|
|Abstract:||Introduction The pros and cons for implementing protocol biopsies (PB) after kidney transplantation are still a matter of debate. We aimed to address the frequency of pathological findings in PB, to analyze their impact on long-term graft survival (GS) and to analyze the risk factors predicting an abnormal histology. Methods We analyzed 946 kidney PB obtained at a median time of 6.5 (±2.9) months after transplantation. Statistics included comparison between groups, Kaplan-Meier and multinomial logistic regression analysis. Results and Discussion PB diagnosis were: 53.4% normal; 46% IFTA; 12.3% borderline and 4.9% had subclinical acute rejection (SCAR). Inflammation had the strongest negative impact on GS. Therefore we split the cases into: "normal without inflammation", "normal with inflammation", "IFTA without inflammation", "IFTA with inflammation" and "rejection" (including SCAR and borderline). 15-year GS in PB diagnosed normal with inflammation was significantly decreased in a similar fashion as in rejection cases. Among normal biopsies, inflammation increased significantly the risk of 15-y graft loss (P = 0.01). Variables that predicted an abnormal biopsy were proteinuria, previous AR and DR-mismatch. Conclusion We conclude that inflammation in normal PB is associated with a significantly lower 15-y GS, comparable to rejection or IFTA with inflammation.|
|Note:||Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0159717|
|It is part of:||PLoS One, 2016, vol. 11, num. 8, p. e0159717|
|Appears in Collections:||Articles publicats en revistes (Ciències Clíniques)|
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