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Delayed Graft Function Under the Microscope: Surveillance Biopsies in Kidney Transplantation

Delayed graft function (DGF) is a common complication of kidney transplantation and frequently leads to the necessity of surveillance biopsies. The purpose of this study is to describe the histological findings in surveillance biopsies of deceased donor kidney transplant recipients and evaluate the...

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Autores principales: Castro Filho, João Batista Saldanha De, Pompeo, Jeferson De Castro, Machado, Rafael Berlezi, Gonçalves, Luiz Felipe Santos, Bauer, Andrea Carla, Manfro, Roberto Ceratti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988887/
https://www.ncbi.nlm.nih.gov/pubmed/35401043
http://dx.doi.org/10.3389/ti.2022.10344
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author Castro Filho, João Batista Saldanha De
Pompeo, Jeferson De Castro
Machado, Rafael Berlezi
Gonçalves, Luiz Felipe Santos
Bauer, Andrea Carla
Manfro, Roberto Ceratti
author_facet Castro Filho, João Batista Saldanha De
Pompeo, Jeferson De Castro
Machado, Rafael Berlezi
Gonçalves, Luiz Felipe Santos
Bauer, Andrea Carla
Manfro, Roberto Ceratti
author_sort Castro Filho, João Batista Saldanha De
collection PubMed
description Delayed graft function (DGF) is a common complication of kidney transplantation and frequently leads to the necessity of surveillance biopsies. The purpose of this study is to describe the histological findings in surveillance biopsies of deceased donor kidney transplant recipients and evaluate the risk factors for graft outcomes. This is a monocentric, retrospective study including kidney transplant recipients that underwent a graft biopsy during the DGF period between January 2006 and July 2019. 356 biopsies were performed in 335 deceased donor transplant recipients. Biopsies were analyzed according to the Banff classification. The main histological findings were: acute tubular necrosis in 150 biopsies (42.1%), acute rejection in 96 biopsies (26.9%), and borderline findings in 91 biopsies (25.5%). In the multivariate analysis, recipient age (p = 0.028) and DGF duration (p = 0.005) were associated with rejection, antibody-induction with anti-thymocyte globulin (ATG) was protective (p = 0.001). The occurrence of rejection was associated with lower death-censored graft survival (log-rank; p = 0.009). Surveillance biopsies of kidney grafts experiencing DGF remain an essential tool for the care of kidney transplant recipients. The recipient’s age and duration of DGF are independent risk factors for acute rejection, while antibody-induction therapy with ATG is associated with protection from its occurrence.
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spelling pubmed-89888872022-04-08 Delayed Graft Function Under the Microscope: Surveillance Biopsies in Kidney Transplantation Castro Filho, João Batista Saldanha De Pompeo, Jeferson De Castro Machado, Rafael Berlezi Gonçalves, Luiz Felipe Santos Bauer, Andrea Carla Manfro, Roberto Ceratti Transpl Int Health Archive Delayed graft function (DGF) is a common complication of kidney transplantation and frequently leads to the necessity of surveillance biopsies. The purpose of this study is to describe the histological findings in surveillance biopsies of deceased donor kidney transplant recipients and evaluate the risk factors for graft outcomes. This is a monocentric, retrospective study including kidney transplant recipients that underwent a graft biopsy during the DGF period between January 2006 and July 2019. 356 biopsies were performed in 335 deceased donor transplant recipients. Biopsies were analyzed according to the Banff classification. The main histological findings were: acute tubular necrosis in 150 biopsies (42.1%), acute rejection in 96 biopsies (26.9%), and borderline findings in 91 biopsies (25.5%). In the multivariate analysis, recipient age (p = 0.028) and DGF duration (p = 0.005) were associated with rejection, antibody-induction with anti-thymocyte globulin (ATG) was protective (p = 0.001). The occurrence of rejection was associated with lower death-censored graft survival (log-rank; p = 0.009). Surveillance biopsies of kidney grafts experiencing DGF remain an essential tool for the care of kidney transplant recipients. The recipient’s age and duration of DGF are independent risk factors for acute rejection, while antibody-induction therapy with ATG is associated with protection from its occurrence. Frontiers Media S.A. 2022-03-24 /pmc/articles/PMC8988887/ /pubmed/35401043 http://dx.doi.org/10.3389/ti.2022.10344 Text en Copyright © 2022 Castro Filho, Pompeo, Machado, Gonçalves, Bauer and Manfro. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Castro Filho, João Batista Saldanha De
Pompeo, Jeferson De Castro
Machado, Rafael Berlezi
Gonçalves, Luiz Felipe Santos
Bauer, Andrea Carla
Manfro, Roberto Ceratti
Delayed Graft Function Under the Microscope: Surveillance Biopsies in Kidney Transplantation
title Delayed Graft Function Under the Microscope: Surveillance Biopsies in Kidney Transplantation
title_full Delayed Graft Function Under the Microscope: Surveillance Biopsies in Kidney Transplantation
title_fullStr Delayed Graft Function Under the Microscope: Surveillance Biopsies in Kidney Transplantation
title_full_unstemmed Delayed Graft Function Under the Microscope: Surveillance Biopsies in Kidney Transplantation
title_short Delayed Graft Function Under the Microscope: Surveillance Biopsies in Kidney Transplantation
title_sort delayed graft function under the microscope: surveillance biopsies in kidney transplantation
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988887/
https://www.ncbi.nlm.nih.gov/pubmed/35401043
http://dx.doi.org/10.3389/ti.2022.10344
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