دورية أكاديمية
أعرض في EDS

The Role of Early Sequential Biopsies in Delayed Renal Graft Function of Transplanted Kidney Is Reduced in Modern Immunosuppression Era.

التفاصيل البيبلوغرافية
العنوان: The Role of Early Sequential Biopsies in Delayed Renal Graft Function of Transplanted Kidney Is Reduced in Modern Immunosuppression Era.
المؤلفون: Guetta O; Department of Organ Transplantation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Osyntsov A; Department of General Surgery B, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel., Rahamimov R; Institute of Nephrology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Tobar A; Department of Pathology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel., Israeli M; Tissue Typing Laboratory, Rabin Medical Center - Beilinson Hospital, Petach Tikva, affiliated to Zefat Academic College, Zefat, Israel., Masarwa Y; Tissue Typing Laboratory, Rabin Medical Center - Beilinson Hospital, Petach Tikva, affiliated to Zefat Academic College, Zefat, Israel., Gurevich M; Department of Organ Transplantation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Tennak V; Department of Organ Transplantation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Mezhybovsky V; Department of Organ Transplantation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Gravetz A; Department of Organ Transplantation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Eisner S; Department of Organ Transplantation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Nesher E; Department of Organ Transplantation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
المصدر: Nephron [Nephron] 2023; Vol. 147 (3-4), pp. 127-133. Date of Electronic Publication: 2022 Jul 29.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Karger Country of Publication: Switzerland NLM ID: 0331777 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2235-3186 (Electronic) Linking ISSN: 16608151 NLM ISO Abbreviation: Nephron Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Basel ; New York : Karger
مواضيع طبية MeSH: Graft Rejection*/pathology , Graft Survival*, Humans ; Retrospective Studies ; Kidney/pathology ; Biopsy/methods ; Immunosuppression Therapy
مستخلص: Background: Delayed graft function (DGF) immediately after kidney transplantation is considered a risk factor for acute rejection. According to clinical guidelines, a weekly allograft biopsy should be performed until DGF resolves. Based on clinical evidence, the first biopsy is considered appropriate. However, the recommendation for further biopsies is based on sparse evidence from era of earlier immunosuppression protocols, and the benefit of the second and further biopsies remains uncertain. The aim of this study was to reevaluate this policy.
Methods: The database of a transplant medical center was retrospectively reviewed for all patients who underwent kidney transplantation in 2011-2020. Those with DGF who performed two or more graft biopsies within the first 60 days after transplantation were identified. Clinical data were collected from the medical files. The rates of diagnosis of acute rejection at the second and subsequent biopsies were analyzed relative to the previous ones.
Results: Kidney transplantation was performed in 1,722 patients during the study period, of whom 225 (13.07%) underwent a total of 351 graft biopsies within 60 days after transplantation, mostly due to DGF. A second biopsy was performed in 32 patients (14.2%), and a third biopsy in 8, at weekly intervals. In 2 patients (6.25%), the diagnosis changed from the first biopsy (acute tubular necrosis or toxic damage) to acute rejection in the second biopsy. In both, the rejection was borderline. Third and fourth biopsies did not add information to the previous diagnosis.
Conclusions: The common practice of performing sequential biopsies during a postoperative course of DGF seems to be of low benefit and should be considered on a case-by-case basis.
(© 2022 The Author(s). Published by S. Karger AG, Basel.)
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فهرسة مساهمة: Keywords: Acute rejection; Allograft biopsy; Delayed graft function; Kidney transplantation
تواريخ الأحداث: Date Created: 20220731 Date Completed: 20230406 Latest Revision: 20230516
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10137296
DOI: 10.1159/000525912
PMID: 35908545
قاعدة البيانات: MEDLINE
الوصف
تدمد:2235-3186
DOI:10.1159/000525912