Biopsy Findings in Renal Allograft Dysfunction in a Live Related Renal Transplant Program

Kazi, Javed Iqbal; Mubarak, Muhammed

doi:10.4172/2161-0991.1000108

Cited by 15 publications

(34 citation statements)

References 28 publications

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“…The causes of allograft dysfunction vary depending on the post-transplant duration, living vs. cadaveric source of organ, type of immunosuppression, underlying or primary disease, etc (Kazi & Mubarak, 2012). It is estimated that 30-50% of allografts develop dysfunction during the early period (John & Herzenberg, 2010).…”

Section: Role Of Renal Allograft Biopsy In the Management Of Renal Trmentioning

confidence: 99%

Pathology of Renal Transplantation

Kazi¹,

Mubarak²

2012

Topics in Renal Biopsy and Pathology

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Section: Role Of Renal Allograft Biopsy In the Management Of Renal Trmentioning

confidence: 99%

Pathology of Renal Transplantation

Kazi¹,

Mubarak²

2012

Topics in Renal Biopsy and Pathology

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“…This may be caused by acute rejection (AR), chronic rejection, calcineurin inhibitor (CNI) toxicity, infections and recurrence of original renal disease [3]. …”

Section: Introductionmentioning

confidence: 99%

Serum Soluble Interleukin 2 Receptor Level as a Marker of Acute Rejection in Pediatric Kidney Transplant Recipients

Hagras

Salah

Ahmed

et al. 2018

Nephron

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Background: Despite advances in immunosuppression, acute allograft rejection remains one of the key factors affecting patient and graft survival in pediatric kidney transplantation. The aim of the study is to evaluate the role of serum soluble IL2 receptor (sIL2R) level as a noninvasive assessment parameter of acute rejection (AR). Method: Serum sIL2R level was measured (using enzyme-linked immune-sorbent assay technique) in 60 pediatric kidney transplant recipients (30 recipients with AR and 30 transplant recipients with stable graft function). Results: The mean values of sIL2R level in patients experiencing AR (14.8 ± 6.54) ng/mL were significantly higher than that in patients with stable graft functions (6.44 ±1.95) ng/mL (p = 0.0001). In addition; patients with AR proved by graft biopsy had their mean values of sIL2R level (16.19 ± 7.48) ng/mL significantly higher than that of other recipients in the study population (p = 0.032). Conclusion: Serum sIL2R level may serve as a noninvasive diagnostic indicator in pediatric kidney transplant recipients experiencing AR.

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“…These often require recourse to the invasive procedure of renal allograft biopsy, which is still the gold standard test for an accurate diagnosis and categorization of rejection, for example [3]. The safety and clinical utility of the biopsy has been proved beyond doubt in numerous clinical studies during the last few decades [5][6][7][8][9][10][11]. However, the pathological interpretation of the biopsies is a daunting task and fraught with interobserver variation.…”

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confidence: 99%

Evolution of the Banff Working Classification of Renal Allograft Pathology: Updates and Future Directions

Mubarak¹

2013

J Transplant Technol Res

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One of the important challenges after renal transplantation is the accurate identification and appropriate management of the graft dysfunction [2,3]. The causes of dysfunction vary depending on many factors, including the time post-transplant, type of immunosuppression used, living vs. cadaveric origin of the organ, and so on [4]. These often require recourse to the invasive procedure of renal allograft biopsy, which is still the gold standard test for an accurate diagnosis and categorization of rejection, for example [3]. The safety and clinical utility of the biopsy has been proved beyond doubt in numerous clinical studies during the last few decades [5][6][7][8][9][10][11]. However, the pathological interpretation of the biopsies is a daunting task and fraught with interobserver variation. Moreover, the pathology of transplantation is continuously evolving [12][13][14][15][16][17]. The Banff classification was introduced to address the above issues in the reporting of renal transplant pathology and to harmonize the reporting of the lesions in a uniform language, which is understood by the clinicians, pathologists, basic scientists and transplant surgeons alike [12,17]. The first meeting of the Banff group took place in 1991 at Banff, Canada and the first detailed publication appeared in 1993 [12,15,17]. Since then, regular meetings of the ever expanding group have been held every two years with timely updates, additions and revisions of the original classification. The aim of these meetings has been to revisit and refine the original classification in the light of accumulating new research and evidence from ongoing studies [12,[17][18][19]. Regarding individual diagnostic categories, major changes have occurred in the categories of antibody-mediated rejection, T-CellMediated Rejection (TCMR) and chronic allograft changes. Some of these evolutionary changes in the diagnostic approach have been reviewed in detail by this author elsewhere [13]. Briefly, the most spectacular changes have taken place in the category of ABMR [13]. The detailed pathology-based diagnostic criteria have been devised and updated for an accurate diagnosis and categorization of ABMR into acute and chronic active categories. The major impetus for this surge in interest in ABMR has been provided by the discovery and the widespread use of c4d as a biomarker for ABMR [20][21][22]. A subtype of ABMR, c4d-negative ABMR has been recognized and a Banff Working Group established to devise the evidence-based criteria of this subtype and to determine the full impact of allo-antibodies on the kidney allograft. A correlation has been found between ABMR diagnosed by histological criteria and molecular profiling. Further work is needed before these diagnostic modalities are merged smoothly into a workable classification [23][24][25][26][27][28]. AbstractRenal transplant pathology is a complex and rapidly evolving field of surgical pathology and the pathologic interpretation of renal allograft biopsy pose significant challenges and opportunities to the ...

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Biopsy Findings in Renal Allograft Dysfunction in a Live Related Renal Transplant Program

Cited by 15 publications

References 28 publications

Pathology of Renal Transplantation

Pathology of Renal Transplantation

Serum Soluble Interleukin 2 Receptor Level as a Marker of Acute Rejection in Pediatric Kidney Transplant Recipients

Evolution of the Banff Working Classification of Renal Allograft Pathology: Updates and Future Directions

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