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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...

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Autores principales: Moinuddin, Irfan, Thajudeen, Bijin, Sussman, Amy, Madhrira, Machaiah, Bracamonte, Erika, Popovtzer, Mordecai, Kadambi, Pradeep V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
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.
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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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