التفاصيل البيبلوغرافية
| العنوان: |
Morphologic and Molecular Features of Antibody-Mediated Transplant Rejection: Pivotal Role of Molecular Injury as an Independent Predictor of Renal Allograft Functional Decline. |
| المؤلفون: |
Herz, Carsten T., Diebold, Matthias, Kainz, Alexander, Mayer, Katharina A., Doberer, Konstantin, Kozakowski, Nicolas, Halloran, Philip F., Böhmig, Georg A. |
| المصدر: |
Transplant International; 2024, p1-13, 13p |
| مصطلحات موضوعية: |
GRAFT rejection, KIDNEY failure, HOMOGRAFTS, KIDNEY diseases, GLOMERULAR filtration rate, WOUNDS & injuries, GRAFT survival |
| مصطلحات جغرافية: |
BANFF (Alta.) |
| مستخلص: |
Current knowledge about the factors correlating with functional decline and subsequent failure of kidney allografts in antibody-mediated rejection (ABMR) is limited. We conducted a cohort study involving 75 renal allograft recipients diagnosed with late ABMR occurring at least 6 months after transplantation. The study aimed to examine the correlation of molecular and histologic features with estimated glomerular filtration rate (eGFR) trajectories and death-censored graft survival. We focused on sum scores reflecting histologic ABMR activity versus chronicity and molecular scores of ABMR probability (ABMRProb), injury-repair response (IRRAT) and fibrosis (ciprob). In multivariable Cox analysis, a Banff lesion-based chronicity index (ci+ct+cg[x2]; hazard ratio per interquartile range [IQR]: 1.97 [95% confidence interval: 0.97 to 3.99]) and IRRAT (1.93 [0.96 to 3.89]) showed the strongest associations with graft failure. Among biopsy variables, IRRAT exhibited the highest relative variable importance and emerged as the sole independent predictor of eGFR slope (change per IQR: −4.2 [−7.8 to −0.6] mL/ min/1.73 m² /year). In contrast, morphologic chronicity associated with baseline eGFR only. We conclude that the extent of molecular injury is a robust predictor of renal function decline. Transcriptome analysis has the potential to improve outcome prediction and possibly identify modifiable injury, guiding targeted therapeutic interventions. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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