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Differences in Pathologic Features and Graft Outcomes of Rejection on Kidney Transplant

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Author(s)
Woo Yeong ParkJin Hyuk PaekKyubok JinSung Bae ParkMisun ChoeSeungyeup Han
Keimyung Author(s)
Park, Woo YoungPaek, Jin HyukJin, Kyu BokPark, Sung BaeChoe, Mi SunHan, Seung Yeup
Department
Dept. of Internal Medicine (내과학)
Dept. of Pathology (병리학)
Journal Title
Transplantation proceedings
Issued Date
2019
Volume
51
Issue
8
Abstract
Background:
Rejection is still a barrier to long-term allograft survival, but there are not many reports of clinical outcomes according to rejection types. The purpose of this study was to investigate differences in pathologic features and graft outcomes of rejection on kidney transplant (KT).

Materials and Methods:
We retrospectively analyzed 139 kidney transplant recipients diagnosed to rejection by allograft biopsy results between 2006 and 2018. We divided kidney transplant recipients into 3 groups as follows: T cell–mediated rejection (TCMR), antibody-mediated rejection, and mixed rejection. We investigated clinical characteristics, pathologic findings, death-censored graft survival rates, and patient survival rates among the 3 groups.

Results:
Mean follow-up duration was 113.5 (SD, 80.6) months. The mixed rejection group was the youngest significantly. There were no significant differences of the proportion of sex, KT type, KT number, number of HLA mismatches, induction immunosuppressant, and maintenance immunosuppressant among the 3 groups. In pathologic findings, microvascular inflammation and C4d were significantly different among the 3 groups. Death-censored graft survival of mixed rejection was the least. In multivariate analysis, recipient age, TCMR, and positive C4d were the risk factors associated with graft failure. However, patient survival rates showed no significant differences among the 3 groups.

Conclusions:
Our study showed that mixed rejection had poor prognosis in comparison with TCMR and antibody-mediated rejection groups, and TCMR and positive C4d were the most important risk factors for graft survival. Therefore, constant monitoring through allograft biopsy and early treatment for rejection are very important in post-transplant clinical outcomes.
Keimyung Author(s)(Kor)
박우영
백진혁
진규복
박성배
최미선
한승엽
Publisher
School of Medicine (의과대학)
Citation
Woo Yeong Park et al. (2019). Differences in Pathologic Features and Graft Outcomes of Rejection on Kidney Transplant. Transplantation proceedings, 51(8), 2655–2659. doi: 10.1016/j.transproceed.2019.02.062
Type
Article
ISSN
1873-2623
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0041134519300715
DOI
10.1016/j.transproceed.2019.02.062
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42416
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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