The impact of subclinical inflammation (SCI) noted on early kidney allograft biopsies remains unclear. This study evaluated the outcome of SCI noted on 3-month biopsy. A total of 273/363 (75%) kidney transplant recipients with a functioning kidney underwent allograft biopsies 3-months posttransplant. Among those with stable allograft function at 3 months, 200 biopsies that did not meet the Banff criteria for acute rejection were identified. These were Group I: No Inflammation (NI, n = 71) and Group II: Subclinical Inflammation (SCI, n = 129). We evaluated differences in kidney function at 24-months and allograft histology score at 12-month biopsy. SCI patients had a higher serum creatinine (1.6 ± 0.7 vs 1.38 ± 0.45; P = .02) at 24-months posttransplant, and at last follow-up at a mean of 42.5 months (1.69 ± 0.9 vs 1.46 ± 0.5 mg/dL; P = .027). The allograft chronicity score (ci + ct + cg + cv) at 12-months posttransplant was higher in the SCI group (2.4 ± 1.35 vs 1.9 ± 1.2; P = .02). The incidence of subsequent rejections within the first year in SCI and NI groups was 24% vs 10%, respectively (P = .015). De novo donor-specific antibody within 12 months was more prevalent in the SCI group (12/129 vs 1/71, P = .03). SCI is likely not a benign finding and may have long-term implications for kidney allograft function.

Introduction: Existing studies report variable impact of vaccination on Coronavirus Disease (COVID-19) morbidity and mortality in solid organ transplant (SOT) recipients. This study aimed to perform a propensity score matching (PSM) analysis on COVID-19 survival of vaccinated and unvaccinated SOT patients who contracted the disease at a single US academic transplant center. Methods: All consecutive COVID-19 positive cases on adult liver, kidney or combined liver-kidney recipients were identified and demographics, comorbidities, immunosuppression, COVID-19 treatment and hospitalization status, COVID-19 vaccination status, and early mortality recorded. PSM study was performed on age and sex for completed vaccination status at time of infection, followed by multivariable analysis and survival curve plotting. Results: 144 SOT patients were diagnosed with COVID-19, with 98 unvaccinated. PSM reduced study number to 101. Matched data multivariable analysis for 60-day mortality identified age and post-kidney transplant status to significantly increase 60-day mortality odds (OR 1.22, p < 0.001 and OR 40.93, p < 0.001, respectively). Kaplan–Meier analysis showed inferior post-infection survival in the unvaccinated group [(30 days; vaccinated vs. unvaccinated 97.8% vs. 89.1%, respectively; p = 0.089) (60 days; 97.8% vs. 83.6%, respectively; p = 0.019)]. Conclusions: Matched data survival analysis demonstrated inferior survival in the unvaccinated group, supporting COVID-19 vaccination in SOT recipients.

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This study aimed to evaluate and compare the in vivo chronic anti-inflammatory efficacy, from the ethyl acetate and ethanolic extracts of Artemisia vulgaris leaves, grown at three different altitudes in Nepal, by formalin-induced paw edema in Swiss albino mice. Edema was induced on the mice paw by administering 0.2% of formalin injection. Indomethacin was used as a standard drug at the concentration of 5 mg/kg of body weight. Ethyl acetate and ethanolic leaves extract, at the concentration of 200 mg/kg and 400 mg/kg, were used as test drugs. Standard drug and all the extracts were administered 30 min before formalin injection. The paw thickness was measured at 0, 1, 2, 3, 24, 48, and 72 hours after formalin injection, using a Vernier caliper. It was observed that both ethyl acetate and ethanolic extract from all the altitudes exhibited significant inhibition of paw edema ( p < 0.05 ) induced by formalin. Maximum activity was shown by 400 mg/kg of the plant leaf extract taken from the temperate zone, with 54.05% of paw edema inhibition, and it is almost similar to the inhibition of standard drug (56.75%). Moreover, the ethanolic extract was found to be more effective than ethyl acetate extract in all the plant samples. The results suggested that the anti-inflammatory effect of A. vulgaris leaves increases with an increase in altitudes and this plant can be used as a useful source of medicine to treat chronic inflammation.