P168112-MONTH SURVEILLANCE BIOPSIES IN RENAL TRANSPLANT PATIENTS AT LOW IMMUNOLOGICAL RISK. ARE THEY STILL WORTH OF BEING DONE?
| العنوان: | P168112-MONTH SURVEILLANCE BIOPSIES IN RENAL TRANSPLANT PATIENTS AT LOW IMMUNOLOGICAL RISK. ARE THEY STILL WORTH OF BEING DONE? |
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| المؤلفون: | Silvio Sandrini, Francesco Scolari, Simona Fisogni, Roberta Cortinovis, Camilla Maffei, Franco Nodari, Nicola Bossini, Alberto Malagoli, Francesca Valerio |
| المصدر: | Nephrology Dialysis Transplantation. 35 |
| بيانات النشر: | Oxford University Press (OUP), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Transplantation, medicine.medical_specialty, Nephrology, Renal transplant, business.industry, Internal medicine, medicine, business |
| الوصف: | Background and Aims In renal transplant field, the progressive increase both of donor and recipient age has led further challenges in patient management. In this setting, the personalization of immunosuppressive therapies (IT) has been strongly suggested. We have investigated renal histology at 12 months after transplantation to assess whether surveillance biopsies (SB) could be considered an additional tool to further improve management of immunosuppression. Method Monocentric retrospective analysis of SB performed 12 months post-transplant (Tx) between 2009-2018. For each SB were collected recipient and donor demographic data, HLA mismatch, induction and maintenance IT, DGF, cold ischemia time, PRA, DSA and nDSA, previous episodes of acute rejection (AR), serum creatinine (Cr) at the time of SB and 1, 3 and 5 years later, histological score according to Banff classification in force at the time of SB. Statistics included comparison between groups and Cox regression. Results We analyzed 209 SB in as many pts, most of them at low immunological risk (first Tx in 94.3%, PRA SB showed normal histology in only 26.3% of cases. There were no differences in renal function between normal and pathological biopsies (Cr 1.40 vs 1.46 mg/dl, p=NS). Major histologic findings, isolated or associated with each other [Fig. 1], were vascular lesions (VL, 40%), IFTA (33%) and inflammatory lesions (IL, 32%). VL correlated with donor age (OR 1.07, p All types of lesions were found to be related with previous AR (VL with OR 3.08, p= 0.003, IFTA with OR 2.15, p=0.04, IL with OR 4.71, p2: 50.5% vs 32%, p=0.045). Indipendent histological variables that predicted a worsening of renal function were glomerulitis/capillaritis (HR 6.996, P Conclusion Our data confirm that stable renal function does not exclude the presence of subclinical histological lesions, even in patients at low immunological risk. Abnormal findings are present in 73.7% of our SB. Glomerulitis/capillaritis and VL can affected renal function, so their recognition should be considered for immunosuppression optimization. Patients with previous AR are at higher risk for all types of histologic lesions and may require a closer monitoring. |
| تدمد: | 1460-2385 0931-0509 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::d4478ff962eed916d74705bfe78de749 https://doi.org/10.1093/ndt/gfaa142.p1681 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........d4478ff962eed916d74705bfe78de749 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14602385 09310509 |
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