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Causes of Kidney Graft Failure in a Cohort of Recipients With a Very Long-Time Follow-Up After Transplantation
BACKGROUND: Biopsy-proven causes of graft loss many years after kidney transplantation are scarcely documented. METHODS: Patients transplanted between 1995 and 2005 (n = 737) in a single center were followed on a regular basis until 2021. The recipients were divided according to age at transplantati...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207199/ https://www.ncbi.nlm.nih.gov/pubmed/35733857 http://dx.doi.org/10.3389/fmed.2022.842419 |
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author | Betjes, Michiel G. H. Roelen, Dave L. van Agteren, Madelon Kal-van Gestel, Judith |
author_facet | Betjes, Michiel G. H. Roelen, Dave L. van Agteren, Madelon Kal-van Gestel, Judith |
author_sort | Betjes, Michiel G. H. |
collection | PubMed |
description | BACKGROUND: Biopsy-proven causes of graft loss many years after kidney transplantation are scarcely documented. METHODS: Patients transplanted between 1995 and 2005 (n = 737) in a single center were followed on a regular basis until 2021. The recipients were divided according to age at transplantation into 3 groups; 18–39 years (young), 40–55 years (middle age), and older than 55 years (elderly). For cause biopsies of renal transplants were clustered into the categories, rejection, IFTA, return original disease, and diagnosis of de novo kidney disease. RESULTS: Rejection was the main cause of graft failure censored for death at every time period after transplantation. The incidence of T cell-mediated rejection (TCMR) became rare 6 years after transplantation while the cumulative incidence of antibody-mediated rejection (ABMR) increased over time (1.1% per year). ABMR was not diagnosed anymore beyond 15 years of follow-up in recipients without pre-transplant donor-specific antibodies (DSA). An episode of TCMR was associated with an increased incidence of ABMR diagnosis in the short-term but did not increase the overall incidence of AMBR not in the long-term. Death as a cause of graft failure was an important competitive risk factor long after transplantation and resulted in a significantly lower frequency of rejection-related graft loss in the elderly group (11 vs. 23% in the young group at 15 year follow-up). CONCLUSION: Rejection is a major cause of graft loss but recipient’s age, time after transplantation, and the presence of DSA before transplantation determine the relative contribution to overall graft loss and the type of rejection involved. |
format | Online Article Text |
id | pubmed-9207199 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92071992022-06-21 Causes of Kidney Graft Failure in a Cohort of Recipients With a Very Long-Time Follow-Up After Transplantation Betjes, Michiel G. H. Roelen, Dave L. van Agteren, Madelon Kal-van Gestel, Judith Front Med (Lausanne) Medicine BACKGROUND: Biopsy-proven causes of graft loss many years after kidney transplantation are scarcely documented. METHODS: Patients transplanted between 1995 and 2005 (n = 737) in a single center were followed on a regular basis until 2021. The recipients were divided according to age at transplantation into 3 groups; 18–39 years (young), 40–55 years (middle age), and older than 55 years (elderly). For cause biopsies of renal transplants were clustered into the categories, rejection, IFTA, return original disease, and diagnosis of de novo kidney disease. RESULTS: Rejection was the main cause of graft failure censored for death at every time period after transplantation. The incidence of T cell-mediated rejection (TCMR) became rare 6 years after transplantation while the cumulative incidence of antibody-mediated rejection (ABMR) increased over time (1.1% per year). ABMR was not diagnosed anymore beyond 15 years of follow-up in recipients without pre-transplant donor-specific antibodies (DSA). An episode of TCMR was associated with an increased incidence of ABMR diagnosis in the short-term but did not increase the overall incidence of AMBR not in the long-term. Death as a cause of graft failure was an important competitive risk factor long after transplantation and resulted in a significantly lower frequency of rejection-related graft loss in the elderly group (11 vs. 23% in the young group at 15 year follow-up). CONCLUSION: Rejection is a major cause of graft loss but recipient’s age, time after transplantation, and the presence of DSA before transplantation determine the relative contribution to overall graft loss and the type of rejection involved. Frontiers Media S.A. 2022-06-06 /pmc/articles/PMC9207199/ /pubmed/35733857 http://dx.doi.org/10.3389/fmed.2022.842419 Text en Copyright © 2022 Betjes, Roelen, van Agteren and Kal-van Gestel. 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 | Medicine Betjes, Michiel G. H. Roelen, Dave L. van Agteren, Madelon Kal-van Gestel, Judith Causes of Kidney Graft Failure in a Cohort of Recipients With a Very Long-Time Follow-Up After Transplantation |
title | Causes of Kidney Graft Failure in a Cohort of Recipients With a Very Long-Time Follow-Up After Transplantation |
title_full | Causes of Kidney Graft Failure in a Cohort of Recipients With a Very Long-Time Follow-Up After Transplantation |
title_fullStr | Causes of Kidney Graft Failure in a Cohort of Recipients With a Very Long-Time Follow-Up After Transplantation |
title_full_unstemmed | Causes of Kidney Graft Failure in a Cohort of Recipients With a Very Long-Time Follow-Up After Transplantation |
title_short | Causes of Kidney Graft Failure in a Cohort of Recipients With a Very Long-Time Follow-Up After Transplantation |
title_sort | causes of kidney graft failure in a cohort of recipients with a very long-time follow-up after transplantation |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207199/ https://www.ncbi.nlm.nih.gov/pubmed/35733857 http://dx.doi.org/10.3389/fmed.2022.842419 |
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