Abstract
The impact of subclinical inflammation (SCI) noted on early kidney allograft biopsies remains unclear. This study evaluated the outcome of SCI noted on 3-month biopsy. A total of 273/363 (75%) kidney transplant recipients with a functioning kidney underwent allograft biopsies 3-months posttransplant. Among those with stable allograft function at 3months, 200 biopsies that did not meet the Banff criteria for acute rejection were identified. These were Group I: No Inflammation (NI, n=71) and Group II: Subclinical Inflammation (SCI, n=129). We evaluated differences in kidney function at 24-months and allograft histology score at 12-month biopsy. SCI patients had a higher serum creatinine (1.6±0.7 vs 1.38±0.45; P=.02) at 24-months posttransplant, and at last follow-up at a mean of 42.5months (1.69±0.9 vs 1.46±0.5mg/dL; P=.027). The allograft chronicity score (ci+ct+cg+cv) at 12-months posttransplant was higher in the SCI group (2.4±1.35 vs 1.9±1.2; P=.02). The incidence of subsequent rejections within the first year in SCI and NI groups was 24% vs 10%, respectively (P=.015). De novo donor-specific antibody within 12months was more prevalent in the SCI group (12/129 vs 1/71, P=.03). SCI is likely not a benign finding and may have long-term implications for kidney allograft function.
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