Diagnosis of renal transplant rejection: Banff classification and beyond

Jeong, Hyeon Joo

doi:10.23876/j.krcp.20.003

Cited by 64 publications

(50 citation statements)

References 65 publications

(86 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, despite the effective immunosuppressive property, long-term TAC treatment causes irreversible kidney injury and adversely affects long-term graft survival [ 3 ]. The histopathologic features of TAC-induced renal injury are arteriolar hyalinization, vasoconstriction, interstitial fibrosis (IF), tubular atrophy, and apoptosis [ 4 , 5 , 6 ]. The pathophysiologic mechanism remains unclear; however, several in vivo and in vitro studies have identified that inflammatory mediates and apoptosis are linked to TAC-induced nephropathy [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Renoprotective Effects of Alpha-1 Antitrypsin against Tacrolimus-Induced Renal Injury

Lim

et al. 2020

IJMS

View full text Add to dashboard Cite

The protective effects of alpha-1 antitrypsin (AAT) in tacrolimus (TAC)-induced renal injury was evaluated in a rat model. The TAC group rats were subcutaneously injected with 2 mg/kg TAC every day for four weeks. The TAC with AAT group was cotreated with daily subcutaneous injections of TAC and intraperitoneal injections of AAT (80 mg/kg) for four weeks. The effects of AAT on TAC-induced renal injury were evaluated using serum biochemistry, histopathology, and Western blotting. The TAC injection significantly increased renal interstitial fibrosis, inflammation, and apoptosis as compared to the control treatment. The histopathological examination showed that cotreatment of TAC and AAT attenuated interstitial fibrosis (collagen, fibronectin, and α-SMA staining), and α-SMA expression in Western blotting was also decreased. Immunohistochemical staining for inflammation (osteopontin and ED-1 staining) revealed improved interstitial inflammation in the TAC with AAT group compared to that in the TAC group. The TAC treatment increased renal apoptosis compared to the control treatment, based on the results of increased immunohistochemical staining of terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL), increased caspase-3 activity, and lower Bcl-2 to Bad expression ratio. However, AAT cotreatment significantly changed these markers and consequently showed decreased apoptosis. AAT protects against TAC-induced renal injury via antifibrotic, anti-inflammatory, and antiapoptotic effects.

show abstract

Section: Introductionmentioning

confidence: 99%

Renoprotective Effects of Alpha-1 Antitrypsin against Tacrolimus-Induced Renal Injury

Lim

et al. 2020

IJMS

View full text Add to dashboard Cite

show abstract

“…Secondary outcomes were the change of homeostatic model assessment for insulin resistance (HOMA-IR) and HOMA-beta, oral glucose tolerance test (OGTT), prescription rate of anti-diabetic medication or insulin, allograft function assessed by allograft survival, patient survival, estimated glomerular filtration rate (eGFR) measured using the modification of diet and renal disease (MDRD)-equation, proportion of patients with significant proteinuria and microalbuminuria (MAU), incidence of biopsy-proven acute rejection (BPAR), all-cause hospitalization, and incidence of BK virus infection nephropathy (BKVN) at 18 months after the KT. Acute rejection included both acute T cell-mediated and acute antibody-mediated rejection, which were diagnosed by the pathologist at each center based on the Banff classification scheme [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Effect of Everolimus with Low-Dose Tacrolimus on Development of New-Onset Diabetes After Transplantation and Allograft Function in Kidney Transplantation: A Multicenter, Open-Label, Randomized Trial

et al. 2021

View full text Add to dashboard Cite

“…Biopsy-proven acute rejection (BPAR) was diagnosed according to the Banff classification [ 24 , 25 ]. Delayed graft function (DGF) was defined as at least one dialysis requirement within the first week after KT [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of acute kidney injury in deceased donors with high Kidney Donor Profile Index on posttransplant clinical outcomes: a multicenter cohort study

Park

Chang

Kim

et al. 2021

Kidney Res Clin Pract

View full text Add to dashboard Cite

Background: This study evaluated the impact of acute kidney injury (AKI) on posttransplant clinical outcomes for deceased donor (DD) kidney transplantation (KT) using the Kidney Donor Profile Index (KDPI) system. Methods: Overall, 657 kidney transplant recipients (KTRs) receiving kidneys from 526 DDs from four transplant centers were included. We divided them into the high and low KDPI donor groups by 65%, the KDPI score, and both groups were subdivided into the AKI-DDKT and non-AKI-DDKT subgroups according to AKI in DDs. Results: There was no significant difference in the incidence of delayed graft function (DGF) between the high and low KDPI-KTR groups; however, the AKI-DDKT subgroup showed significantly higher incidence of DGF than the non-AKI-DDKT subgroup in both groups (p = 0.001, p < 0.001, respectively). The death-censored graft survival rate was significantly lower in the high KDPI-KTR group than in the low KDPI-KTR group (p = 0.005). Only in the high KDPI-KTR group, the death-censored graft survival rate was significantly lower in the KT from DDs with AKI stage 3 than KT from DDs with non-AKI or AKI stage 1 or 2 (p = 0.040). The interaction between AKI stage 3 in DDs and high KDPI on the allograft outcome was significant (p = 0.002). Conclusion: KTs from DDs with AKI stage 3 showed an adverse impact on the allograft outcome in the high KDPI-KTR group. Therefore, DDs with a high KDPI score should be managed carefully so that severe AKI does not occur prior to KT.

show abstract

Diagnosis of renal transplant rejection: Banff classification and beyond

Cited by 64 publications

References 65 publications

Renoprotective Effects of Alpha-1 Antitrypsin against Tacrolimus-Induced Renal Injury

Renoprotective Effects of Alpha-1 Antitrypsin against Tacrolimus-Induced Renal Injury

Effect of Everolimus with Low-Dose Tacrolimus on Development of New-Onset Diabetes After Transplantation and Allograft Function in Kidney Transplantation: A Multicenter, Open-Label, Randomized Trial

Impact of acute kidney injury in deceased donors with high Kidney Donor Profile Index on posttransplant clinical outcomes: a multicenter cohort study

Contact Info

Product

Resources

About