Single center experience of subclinical rejections and BK nephropathies by kidney allografts’ surveillance biopsies

Naumnik, Beata; Kowalewska, Jolanta; Hryszko, Tomasz; Głowiński, Jerzy; Durlik, M.; Myśliwiec, M

doi:10.1016/j.advms.2016.07.005

Cited by 3 publications

(10 citation statements)

References 27 publications

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“…From 2875 unique citations identified through our systematic literature search, 12 studies 8 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 (involving 1255 participants) met our eligibility criteria (Figure 1 ). The characteristics of these studies are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Half of the studies ( n = 6) were from the United States of America (USA), 24 , 26 , 27 , 28 , 30 , 33 two studies were from Canada, 29 , 34 while one study each was from Australia, 31 France, 8 Poland, 32 and Taiwan. 25 There was one randomized controlled trial (RCT), 24 two multicenter prospective observational cohorts, 27 , 29 five single center prospective observational cohorts, 8 , 26 , 28 , 30 , 32 and four single‐center retrospective cohorts. 25 , 31 , 33 , 34 Two studies reported receiving industry funding.…”

Section: Resultsmentioning

confidence: 99%

“…The index BPAR event largely occurred within the first year with two studies reporting an index BPAR at 2 years posttransplant. 25,27 In terms of index rejection severity, four studies reported ≥Banff 1A, 8,26,28,32 six reported ≥Banff Borderline rejection, 25,27,29,31,33,34 and two studies reported tubulointerstitial inflammation ≤Banff Borderline by the Banff 2005 criteria. 24,30 Four studies defined borderline rejection with the Banff 1997 criteria requiring at least ≥i1 score.…”

Section: Index Rejection Event Immunosuppression and Treatmentmentioning

confidence: 99%

“…Poland, 32 and Taiwan. 25 There was one randomized controlled trial (RCT), 24 two multicenter prospective observational cohorts, 27,29 five single center prospective observational cohorts, 8,26,28,30,32 and four single-center retrospective cohorts. 25,31,33,34 Two studies reported receiving industry funding.…”

Section: Systematic Review and Study Characteristicsmentioning

confidence: 99%

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Effectiveness of T cell–mediated rejection therapy: A systematic review and meta-analysis

Okoli

Rabbani

et al. 2022

American Journal of Transplantation

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Index Rejection Event Immunosuppression and Treatmentmentioning

confidence: 99%

Section: Systematic Review and Study Characteristicsmentioning

confidence: 99%

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Effectiveness of T cell–mediated rejection therapy: A systematic review and meta-analysis

Okoli

Rabbani

et al. 2022

American Journal of Transplantation

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“…Unfortunately, the retrospective design of our study does not allow us to make any authoritative conclusions whether this resolution should be ascribed to treatment effect or a spontaneous repair process as all our IV patients but one received antirejection therapy. The body of evidence in the relevant literature related to prognosis of subclinical and untreated IV is limited . Further studies are warranted to investigate the nature of IV and draw conclusions regarding the treatment effect on kidney graft survival.…”

Section: Discussionmentioning

confidence: 99%

Isolated v-lesion represents a benign phenotype of vascular rejection of the kidney allograft - a retrospective study

et al. 2018

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While the detrimental impact of the humoral acute vascular rejection (AVR) phenotype is recognized, the prognostic significance of isolated v-lesion (IV) remains unclear. In this retrospective single-centre study, AVR was found in 98 of 1015 patients (9.7%) who had undergone kidney transplantation in 2010-2014, with donor-specific antibodies (DSA) evaluated in all of them. The outcome of four AVR phenotypes was evaluated during median follow-up of 59 months; in 25 patients with IV, 18 with T-cell-mediated vascular rejection (TCMVR), 19 with antibody-mediated vascular rejection (AMVR) and 36 with suspected antibody-mediated rejection (sAMVR). AVR was diagnosed mainly by for-cause biopsy (81%) early after transplantation (median 19 POD) and appeared as mild-grade intimal arteritis. IV occurred in low-sensitized patients after the first transplantation (96%) in the absence of DSA. IV responded satisfactorily to treatment (88%), showed no persistence of rejection in surveillance biopsy, and had stable graft function, minimal proteinuria and excellent DCGS (96%). Contrary to that, Kaplan-Meier estimate of 3-year DCGS of AMVR was 66% (log-rank = 0.0004). Early IV represents a benign phenotype of AVR with a favourable outcome. This study prompts further research to evaluate the nature of IV before considering any change in the classification and management.

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The Role of Protocol Allograft Biopsies in Postrenal Transplantation: A Systematic Review and Meta-analysis

Shukla,

Naik,

Niranjan

et al. 2024

Indian Journal of Transplantation

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Introduction: Kidney transplantation is the preferred treatment for end-stage kidney disease, offering improved outcomes compared to dialysis. However, factors such as immunological rejection, drug toxicity, and infections limit its success. Incorporating protocol biopsies (PBs) into standard care for kidney transplant recipients varies widely. This study aims to review the literature on the practice, histopathological findings, and benefits of performing PB on allograft function. Materials and Methods: A systematic review was conducted using PubMed, ScienceDirect, and other databases from 2000 to 2023. Studies describing findings of PBs within 2 years posttransplant were included. Data extraction covered study design, immunosuppression, biopsy timing, incidence of subclinical rejection (SCR), clinical rejection, and allograft function measures. Statistical analysis was performed using R and RevMan software. Results: Among 25 studies (3384 patients) included, 8 were randomized controlled studies. Protocol biopsy timing varied, with the highest number performed at 1 year (44.84%). The pooled incidence of SCR was 13%, with heterogeneity across estimates. Subgroup analysis did not reveal significant differences in SCR rates between high- and low-immunologic risk patients. Patients who underwent PBs had lower clinical rejection rates (12.64% vs. 20.17%) and better allograft function. Incidence of calcineurin inhibitor toxicity ranged from 1.2% to 63.4%, and BK virus nephropathy ranged from 0% to 5.9% in included studies. Conclusion: Performing PB at 6 months, 1 year, and 2 years posttransplant can reveal SCR and potentially improve long-term graft outcomes. Treatment of SCR may reduce clinical rejection episodes. However, further research, particularly comparing PB with noninvasive methods, is needed to better understand their efficacy and complications in the modern transplant landscape.

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Single center experience of subclinical rejections and BK nephropathies by kidney allografts’ surveillance biopsies

Cited by 3 publications

References 27 publications

Effectiveness of T cell–mediated rejection therapy: A systematic review and meta-analysis

Effectiveness of T cell–mediated rejection therapy: A systematic review and meta-analysis

Isolated v-lesion represents a benign phenotype of vascular rejection of the kidney allograft - a retrospective study

The Role of Protocol Allograft Biopsies in Postrenal Transplantation: A Systematic Review and Meta-analysis

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