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Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis
Acute vascular rejection (AVR) is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection (AIR) and AVR is associated with a higher rate of graft loss than AIR. The prognosis and trea...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4886071/ https://www.ncbi.nlm.nih.gov/pubmed/27293950 http://dx.doi.org/10.1155/2016/4603014 |
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author | Moinuddin, Irfan Thajudeen, Bijin Sussman, Amy Madhrira, Machaiah Bracamonte, Erika Popovtzer, Mordecai Kadambi, Pradeep V. |
author_facet | Moinuddin, Irfan Thajudeen, Bijin Sussman, Amy Madhrira, Machaiah Bracamonte, Erika Popovtzer, Mordecai Kadambi, Pradeep V. |
author_sort | Moinuddin, Irfan |
collection | PubMed |
description | Acute vascular rejection (AVR) is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection (AIR) and AVR is associated with a higher rate of graft loss than AIR. The prognosis and treatment of arteritis without tubulitis and interstitial inflammation (isolated v1 lesion) are still controversial. We report a case of a patient who had a biopsy of the kidney allograft for evaluation of slow graft function. The biopsy revealed an isolated v1 lesion. However, we chose not to augment immunosuppression. The patient's kidney allograft function improved over time with close monitoring. Repeat biopsy a year later showed no evidence of endothelialitis and relatively unchanged fibrosis and no other abnormalities. Although it is suggested that most cases of isolated v1 lesions will respond to corticosteroids or T cell depleting therapies, some cases will improve with conservative management. Further studies are needed to determine which cases could be managed conservatively. |
format | Online Article Text |
id | pubmed-4886071 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-48860712016-06-12 Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis Moinuddin, Irfan Thajudeen, Bijin Sussman, Amy Madhrira, Machaiah Bracamonte, Erika Popovtzer, Mordecai Kadambi, Pradeep V. Case Rep Transplant Case Report Acute vascular rejection (AVR) is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection (AIR) and AVR is associated with a higher rate of graft loss than AIR. The prognosis and treatment of arteritis without tubulitis and interstitial inflammation (isolated v1 lesion) are still controversial. We report a case of a patient who had a biopsy of the kidney allograft for evaluation of slow graft function. The biopsy revealed an isolated v1 lesion. However, we chose not to augment immunosuppression. The patient's kidney allograft function improved over time with close monitoring. Repeat biopsy a year later showed no evidence of endothelialitis and relatively unchanged fibrosis and no other abnormalities. Although it is suggested that most cases of isolated v1 lesions will respond to corticosteroids or T cell depleting therapies, some cases will improve with conservative management. Further studies are needed to determine which cases could be managed conservatively. Hindawi Publishing Corporation 2016 2016-05-17 /pmc/articles/PMC4886071/ /pubmed/27293950 http://dx.doi.org/10.1155/2016/4603014 Text en Copyright © 2016 Irfan Moinuddin et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Moinuddin, Irfan Thajudeen, Bijin Sussman, Amy Madhrira, Machaiah Bracamonte, Erika Popovtzer, Mordecai Kadambi, Pradeep V. Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
title | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
title_full | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
title_fullStr | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
title_full_unstemmed | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
title_short | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
title_sort | early posttransplant isolated v1 lesion does not need to be treated and does not lead to increased fibrosis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4886071/ https://www.ncbi.nlm.nih.gov/pubmed/27293950 http://dx.doi.org/10.1155/2016/4603014 |
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