Glomerular damage as a predictor of renal allograft loss

Moscoso-Solorzano, Grace Tamara; Câmara, Niels Olsen Saraiva; Franco, Marcello; Araújo, Sérgio de; Ortega, Francisco; Pacheco-Silva, Álvaro; Kirsztajn, Gianna Mastroianni

doi:10.1590/s0100-879x2010007500039

Cited by 1 publication

(4 citation statements)

References 40 publications

(49 reference statements)

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“…However, it is evident that TG may be detected in the absence of DSAs, perhaps reflecting the relapsing nature of the immune injury [60]. Hepatitis C virus may be associated with TG, and appeared as a risk factor for graft loss in two of the studies analyzed here [34,45], although whether this was due to progression of the specific lesion was uncertain.…”

Section: Plos Onementioning

confidence: 84%

“…The search strategy yielded 5,397 publications, of which 4,299 abstracts were screened and 215 published articles were reviewed. After full-text review, 194 publications were eliminated based on the eligibility criteria, leaving a total of 21 studies comprising 6,783 patients for potential inclusion in the meta-analysis [26,[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. Because not all subgroups of patients reported were relevant for the analysis, data for 5,833 patients were ultimately included.…”

Section: Literature Searchmentioning

confidence: 99%

“…All but five of the 21 studies provided graft loss-related data as the only end point, either censored for death or not. In the remaining five studies, the combined end points labeled as "death-censored graft failure" included graft loss and some laboratory measure of graft dysfunction-namely, the doubling of serum creatinine levels (Lesage 2015 [42]), >50% reduction in GFR beyond 1 year (Cosio 2005 [26]), GFR <15 mL/min/1.73 m 2 (Moscoso-Solorzano 2010 [45]), or serum creatinine level �150% of the baseline value (Sijpkens 2004 [47]); Parajuli et al [52] did not specify the criteria for failure. Most studies applied explicit censoring for death or death censoring that was deduced from the study design.…”

Section: Plos Onementioning

confidence: 99%

“…Kieran 2009 [40],Kikić 2015 [41], Lesage 2015 [42], Moktefi 2017 [44], Sijpkens 2004 [47], Vongwiwatana 2004 [50]), molecular changes in the graft (Loupy 2014 [43]), and treatment (Mulley 2017[53]). Four studies described the primary importance of TG, the association with DSA and/or C4d deposition, or the potentially confounding influence of hepatitis C virus on the phenotype of graft failure (Cruzado 2011[34], Moscoso-Solorzano 2010[45], Sun 2012[48],Suri 2000 …”

mentioning

confidence: 99%

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Association between transplant glomerulopathy and graft outcomes following kidney transplantation: A meta-analysis

Kovács¹,

Devercelli

Zelei³

et al. 2020

PLoS ONE

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Transplant glomerulopathy (TG), a morphological lesion associated with confluent mechanisms of endothelial injury of renal allografts, may provide a viable predictor of graft failure. This systematic literature review and meta-analysis were performed according to the PRISMA statement to examine evidence describing the association between TG and graft loss or failure and time to these events. The literature review was conducted using the Scopus, EBSCO, and Cochrane Library search engines. Hazard ratios, median survival times, and 95% confidence intervals (CIs) were estimated to evaluate graft survival in the total population and prespecified subgroups. Meta-regression analysis assessed heterogeneity. Twenty-one publications comprising 6,783 patients were eligible for data extraction and inclusion in the meta-analysis. Studies were highly heterogeneous (I 2 = 67.3%). The combined hazard ratio of graft loss or failure from random-effects meta-analysis was 3.11 (95% CI 2.44-3.96) in patients with TG compared with those without. Median graft survival in patients with TG was 3.25 (95% CI 0.94-11.21) years-15 years shorter than in those without TG (18.82 [95% CI 10.03-35.32] years). The effect of time from transplantation to biopsy on graft outcomes did not reach statistical significance (p = 0.116). TG was associated with a threefold increase in the risk of graft loss or failure and a 15-year loss in graft survival, indicating viability as a surrogate measure for both clinical practice and studies designed to prevent or reverse antibody-mediated rejection.

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Section: Plos Onementioning

confidence: 84%